Provider Demographics
NPI:1477676310
Name:EASON, CHERYL
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:EASON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 NE LOTUS DR APT 26
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6153
Mailing Address - Country:US
Mailing Address - Phone:503-871-6002
Mailing Address - Fax:
Practice Address - Street 1:1128 NW HARRIMAN ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-1947
Practice Address - Country:US
Practice Address - Phone:541-322-7492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-07
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator