Healthcare Provider Details

I. General information

NPI: 1396640579
Provider Name (Legal Business Name): JOSHUA CLEMENT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 OHAI ST
HILO HI
96720-2354
US

IV. Provider business mailing address

333 OHAI ST
HILO HI
96720-2354
US

V. Phone/Fax

Practice location:
  • Phone: 808-935-2188
  • Fax:
Mailing address:
  • Phone: 808-935-2188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: