Miranda Cannon PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD60160071 Issued in WA

Legal business name

MIRANDA CANNON PLLC

Practice address

504 Barnes Blvd BLDG 504
McChord Main Exchange Optometry Center
Joint Base Lewis McChord, WA 98438-1304

Phone

(253) 588-1741

Fax

(253) 588-1731

NPI assigned

Jan 5, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Miranda M Cannon, O.D.

Title

Owner

Phone

(206) 714-8606

Specialties & licenses 1

Addresses

Other names 1

• McChord Optometry Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483574400000",
    "number": "1801331541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 BARNES BLVD BLDG 504",
            "address_2": "MCCHORD MAIN EXCHANGE OPTOMETRY CENTER",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984381304",
            "telephone_number": "253-588-1741",
            "fax_number": "253-588-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 BARNES BLVD BLDG 504",
            "address_2": "MCCHORD MAIN EXCHANGE OPTOMETRY CENTER",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984381304",
            "telephone_number": "253-588-1741",
            "fax_number": "253-588-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRANDA CANNON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-05",
        "last_updated": "2017-01-05",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-714-8606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60160071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McChord Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madeline Kay Merriam, DPT
• Donielle Frances Miller-Hesse, DO
• Daniel Scott Miller, IDMT
• Matthew Christopher Miller, M.D.
• Chadwick Austin Milligan
• Allison Perry Mitchell, CNM
• Jodie Mitchell
• Kyle William Martin Mogensen
• Jayce Moody
• Jessica Marie Moore, LMP

• Optometrist in Joint Base Lewis McChord, WA
• Providers in Joint Base Lewis McChord, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.