Georgiaanne Tuesday Bastow, CRM
Peer Specialist in Newport, OR. Individual provider (NPI-1).
NPI number1619710100
StatusActive
Last updated in NPPESJun 13, 2024
Details
- NPI
- 1619710100
- Entity type
- Individual (NPI-1)
- Name
- Georgiaanne Tuesday Bastow
- Credential
- CRM
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 13, 2024
- Certification date
- Jun 13, 2024
- Last updated
- Jun 13, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | 24-CRM-2996 | OR | Yes |
Practice location
Po Box 1538Newport, OR 97365-0115
Phone 541-574-9570 · Fax 541-574-8857
Mailing address
Po Box 1538Newport, OR 97365-0115
Phone 541-574-9570 · Fax 541-574-8857
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