Healthcare Provider Details

I. General information

NPI: 1922947696
Provider Name (Legal Business Name): HAWAII WELLNESS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD STE 1002
HONOLULU HI
96814-4405
US

IV. Provider business mailing address

1441 KAPIOLANI BLVD STE 1002
HONOLULU HI
96814-4405
US

V. Phone/Fax

Practice location:
  • Phone: 808-201-2343
  • Fax:
Mailing address:
  • Phone: 808-201-2343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: PHILIP SCHLIEDER
Title or Position: HEAD OF BUSINESS DEVELOPMENT
Credential:
Phone: 808-451-8763