Provider Demographics
NPI:1902950835
Name:LENTZ, JAMES THOMAS (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THOMAS
Last Name:LENTZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6720 NE 84TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-2016
Mailing Address - Country:US
Mailing Address - Phone:360-828-2265
Mailing Address - Fax:360-828-2291
Practice Address - Street 1:6720 NE 84TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-2016
Practice Address - Country:US
Practice Address - Phone:360-828-2265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3535152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist