Individual
LANCE MARTIN STANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
606 NE BROADWAY ST, PORTLAND, OR 97232-1212
(844) 966-6777
Mailing address
1455 NW IRVING ST STE 600, PORTLAND, OR 97209-2277
(620) 375-2233
(620) 375-4954
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
PA60960296
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA184907
OREGON MEDICAL BOARD
OR
Enumeration date
08/14/2016
Last updated
12/19/2024
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