Provider Demographics
NPI:1821289612
Name:MCADOO, THERESA ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:ANN
Last Name:MCADOO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:THERESA
Other - Middle Name:ANN
Other - Last Name:MEHARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7855 SW DARTMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223
Mailing Address - Country:US
Mailing Address - Phone:503-639-8632
Mailing Address - Fax:503-530-2008
Practice Address - Street 1:7855 SW DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223
Practice Address - Country:US
Practice Address - Phone:503-639-8632
Practice Address - Fax:503-530-2008
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2245-ATI152W00000X
WA1955-TX152W00000X
AZ1271152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist