Healthcare Provider Details

I. General information

NPI: 1508778309
Provider Name (Legal Business Name): MAIKO OGAWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 KINAU ST
HONOLULU HI
96814-1414
US

IV. Provider business mailing address

5483 OPIHI ST
HONOLULU HI
96821-1956
US

V. Phone/Fax

Practice location:
  • Phone: 808-587-4414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: