Provider Demographics
NPI:1588693113
Name:BASSETT, GERALD A (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:A
Last Name:BASSETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 E PENNY RD STE C
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-8127
Mailing Address - Country:US
Mailing Address - Phone:509-664-0530
Mailing Address - Fax:509-665-8043
Practice Address - Street 1:175 E PENNY RD STE C
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-8127
Practice Address - Country:US
Practice Address - Phone:509-664-0530
Practice Address - Fax:509-665-8043
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00020039207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8787BAOtherREGENCE RIDER#
WA8337800Medicaid
WAA07530Medicare UPIN