Healthcare Provider Details

I. General information

NPI: 1417874017
Provider Name (Legal Business Name): KELSON KENJI OSHIRO DNP, APRN-RX
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86-260 FARRINGTON HWY
WAIANAE HI
96792-3128
US

IV. Provider business mailing address

86-260 FARRINGTON HWY
WAIANAE HI
96792-3128
US

V. Phone/Fax

Practice location:
  • Phone: 808-697-3300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number5989
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: