Provider Demographics
NPI:1437303898
Name:SHERMAN OPTICAL LLC
Entity Type:Organization
Organization Name:SHERMAN OPTICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:SCHEUERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:425-771-8226
Mailing Address - Street 1:21616 76TH AVE W STE 106
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7512
Mailing Address - Country:US
Mailing Address - Phone:425-771-8226
Mailing Address - Fax:425-640-3217
Practice Address - Street 1:21616 76TH AVE W STE 106
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7512
Practice Address - Country:US
Practice Address - Phone:425-771-8226
Practice Address - Fax:425-640-3217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-12
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602841519332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6160430001Medicare NSC