Healthcare Provider Details

I. General information

NPI: 1396208112
Provider Name (Legal Business Name): SHAWN ANDREW STRAUSBURG LISW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JARRETT WHITE RD
TRIPLER ARMY MEDICAL CENTER HI
96859-5001
US

IV. Provider business mailing address

1 JARRETT WHITE RD
TRIPLER ARMY MEDICAL CENTER HI
96859-5001
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-6661
  • Fax: 808-433-1551
Mailing address:
  • Phone: 808-433-6661
  • Fax: 808-433-1551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2103266
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: