Healthcare Provider Details

I. General information

NPI: 1861928400
Provider Name (Legal Business Name): KEATON OSHIRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2017
Last Update Date: 09/11/2025
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N VINEYARD BLVD STE 153
HONOLULU HI
96817-3938
US

IV. Provider business mailing address

99-870 IWAENA ST STE 101
AIEA HI
96701-3278
US

V. Phone/Fax

Practice location:
  • Phone: 808-523-8188
  • Fax: 808-524-8186
Mailing address:
  • Phone: 808-277-7736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: