Individual
DR. JATINDER BANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1200 STATION DR, #150, DUPONT, WA 98327-9804
(253) 912-2020
(253) 579-1153
Mailing address
345 COLLEGE ST SE, STE C, LACEY, WA 98503-1014
(360) 923-4330
(360) 456-3894
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD4053
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2012279
—
WA
Enumeration date
10/05/2006
Last updated
09/13/2011
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