Healthcare Provider Details

I. General information

NPI: 1750851051
Provider Name (Legal Business Name): JASON ANTHONY LIEW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2018
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1164 BISHOP ST STE 1710
HONOLULU HI
96813-2860
US

IV. Provider business mailing address

1164 BISHOP ST STE 1710
HONOLULU HI
96813-2860
US

V. Phone/Fax

Practice location:
  • Phone: 808-261-7792
  • Fax: 808-792-0034
Mailing address:
  • Phone: 808-261-7792
  • Fax: 808-792-0034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD-26454
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: