Provider Demographics
NPI:1447934534
Name:MCCANN, ANNA (OD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MCCANN
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:PAFFRATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:7421 SW BARBUR BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-2887
Mailing Address - Country:US
Mailing Address - Phone:503-343-1603
Mailing Address - Fax:503-343-1604
Practice Address - Street 1:502 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOLALLA
Practice Address - State:OR
Practice Address - Zip Code:97038-9148
Practice Address - Country:US
Practice Address - Phone:503-829-9186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORATI4675152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist