Healthcare Provider Details

I. General information

NPI: 1265568489
Provider Name (Legal Business Name): MRS. CARLEEN JALE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 04/05/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3221 WAIALAE AVE SUITE #345
HONOLULU HI
96816-5842
US

IV. Provider business mailing address

3221 WAIALAE AVE SUITE #345
HONOLULU HI
96816-5842
US

V. Phone/Fax

Practice location:
  • Phone: 808-732-5223
  • Fax: 808-735-9598
Mailing address:
  • Phone: 808-732-5223
  • Fax: 808-735-9598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number101
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: