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General NPI Number Information
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NPI Number | 1437303898
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Entity Type | Organization
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Legal Business Name | SHERMAN OPTICAL LLC
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Dates
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Enumeration Date | 11/12/2008
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Last Update Date | 03/27/2009
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Provider Practice Location Address
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Address Line | 21616 76TH AVE W STE 106
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City | EDMONDS
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State | WA
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Zip | 98026-7512
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Country | US
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Telephone | 425-771-8226
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Fax | 425-640-3217
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Provider Business Mailing Address
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Address Line | 21616 76TH AVE W STE 106
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City | EDMONDS
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State | WA
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Zip | 98026-7512
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Country | US
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Telephone | 425-771-8226
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Fax | 425-640-3217
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Authorized Official
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Title or Position | OWNER
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Name | MR. MICHAEL SEAN SCHEUERMAN
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Credential | LDO
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Telephone | 425-771-8226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 602841519
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License Number State | WA
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