Provider Demographics
NPI:1033256599
Name:TAN, KAREN (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:TAN
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 WARD AVENUE
Mailing Address - Street 2:STE 105
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814
Mailing Address - Country:US
Mailing Address - Phone:808-591-8778
Mailing Address - Fax:808-597-8282
Practice Address - Street 1:320 WARD AVE
Practice Address - Street 2:STE 105
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4001
Practice Address - Country:US
Practice Address - Phone:808-591-8778
Practice Address - Fax:808-597-8282
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU 394171100000X
HI107175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered175F00000XOther Service ProvidersNaturopath