Provider Demographics
NPI:1518171610
Name:MCMAHAN, CHERI ANNE (OPTICIAN)
Entity Type:Individual
Prefix:MS
First Name:CHERI
Middle Name:ANNE
Last Name:MCMAHAN
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36775 HIGHWAY 26
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-7211
Mailing Address - Country:US
Mailing Address - Phone:503-668-7931
Mailing Address - Fax:
Practice Address - Street 1:36775 HIGHWAY 26
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-7211
Practice Address - Country:US
Practice Address - Phone:503-668-7931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician