Healthcare Provider Details

I. General information

NPI: 1780179846
Provider Name (Legal Business Name): TRAVIS K. OHASHI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45-045 KAMEHAMEHA HWY
KANEOHE HI
96744-5221
US

IV. Provider business mailing address

1445 ALA NAPUNANI ST
HONOLULU HI
96818-1526
US

V. Phone/Fax

Practice location:
  • Phone: 808-544-0200
  • Fax:
Mailing address:
  • Phone: 808-517-7180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-2403
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: