Provider Demographics
NPI:1427383785
Name:DUMONT, CHERYL L (OD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:L
Last Name:DUMONT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4484 NW WOODGATE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229
Mailing Address - Country:US
Mailing Address - Phone:208-667-1802
Mailing Address - Fax:208-667-1285
Practice Address - Street 1:3879 N SCHREIBER WAY
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815
Practice Address - Country:US
Practice Address - Phone:208-667-1802
Practice Address - Fax:208-667-1285
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT662152WL0500X
IDODP-100046152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation