Individual
DR. LANCE MINTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
9606 271ST ST NW, STANWOOD, WA 98292-8096
(360) 939-0604
Mailing address
9606 271ST ST NW, STANWOOD, WA 98292-8096
(360) 939-0604
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3257
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2034742
—
WA
01
—
3257
STATE LICENSE NUMBER
WA
Enumeration date
10/03/2006
Last updated
01/21/2022
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