Healthcare Provider Details

I. General information

NPI: 1396609160
Provider Name (Legal Business Name): LAUREN WATANABE MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N VINEYARD BLVD # A325
HONOLULU HI
96817-3950
US

IV. Provider business mailing address

200 N VINEYARD BLVD # A325
HONOLULU HI
96817-3950
US

V. Phone/Fax

Practice location:
  • Phone: 551-333-3346
  • Fax:
Mailing address:
  • Phone: 551-333-3346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: LAUREN WATANABE
Title or Position: OWNER
Credential: MD, MPH
Phone: 808-398-6051