Healthcare Provider Details

I. General information

NPI: 1902710205
Provider Name (Legal Business Name): MARIAH URUSHIYAMA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIAH CASTRO

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 5870
HILO HI
96720-8870
US

IV. Provider business mailing address

PO BOX 5870
HILO HI
96720-8870
US

V. Phone/Fax

Practice location:
  • Phone: 808-896-5621
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN-101592
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: