Most Relevant Information
Provider Data
| NPI Number: | 1003586132 |
| Provider Name: | JARED BASHAW |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | 24-01213 |
Most Important Dates
| Enumeration Date: | 09/20/2021 |
| Last Updated: | 09/20/2021 |
Provider Practice Location
1800 VILLAGE WEST PKWY
KANSAS CITY
KS
661111825
Practice Location Phone/Fax
| Phone: | 9133285618 |
| Fax: |
Provider Mailing Location
13320 HAUSER ST APT 3303
OVERLAND PARK
KS
662132477
Provider Mailing Phone/Fax
| Phone: | 6202182855 |
| Fax: |