Healthcare Provider Details

I. General information

NPI: 1669087896
Provider Name (Legal Business Name): MICHAEL J PALAZZO PHD APRN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2020
Last Update Date: 08/20/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 SAND ISLAND ACCESS RD STE 200
HONOLULU HI
96819-4901
US

IV. Provider business mailing address

37 S WENATCHEE AVE STE F308
WENATCHEE WA
98801-2255
US

V. Phone/Fax

Practice location:
  • Phone: 808-533-3936
  • Fax:
Mailing address:
  • Phone: 808-909-2003
  • Fax: 808-909-2004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL J PALAZZO
Title or Position: DR.
Credential: PHD, APRN
Phone: 808-537-2273