Healthcare Provider Details

I. General information

NPI: 1679469373
Provider Name (Legal Business Name): MARY KATHRYN ANN MABRY DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

549 HALEMAUMAU ST STE D3
HONOLULU HI
96821-2150
US

IV. Provider business mailing address

4711 NATICK AVE APT 329
SHERMAN OAKS CA
91403-2792
US

V. Phone/Fax

Practice location:
  • Phone: 808-637-2608
  • Fax: 808-748-0161
Mailing address:
  • Phone: 310-484-9164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-1667
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: