Provider Demographics
NPI:1154675189
Name:CHERIYAN, SHARON S (OD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:S
Last Name:CHERIYAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:THANNICKAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:13304 94TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-5502
Mailing Address - Country:US
Mailing Address - Phone:971-732-4866
Mailing Address - Fax:
Practice Address - Street 1:13304 94TH AVENUE CT E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-5502
Practice Address - Country:US
Practice Address - Phone:425-369-6726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60296735152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist