Provider Demographics
NPI:1043086382
Name:BASTEN, REID (HAS)
Entity Type:Individual
Prefix:MR
First Name:REID
Middle Name:
Last Name:BASTEN
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 OAKWOOD RD UNIT 319
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014-8315
Mailing Address - Country:US
Mailing Address - Phone:319-461-4450
Mailing Address - Fax:
Practice Address - Street 1:305 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8205
Practice Address - Country:US
Practice Address - Phone:515-233-5193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA108649237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist