Healthcare Provider Details

I. General information

NPI: 1497734206
Provider Name (Legal Business Name): LIANNE EMI HASEGAWA-EVANS C.G.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD
HONOLULU HI
96814-4408
US

IV. Provider business mailing address

741 SUNSET AVE
HONOLULU HI
96816-2311
US

V. Phone/Fax

Practice location:
  • Phone: 808-973-3403
  • Fax: 808-973-3401
Mailing address:
  • Phone: 808-733-9039
  • Fax: 808-733-9068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: