Provider Demographics
NPI:1275896433
Name:SHANER, KRISTINE LAYUGAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:LAYUGAN
Last Name:SHANER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KRISTINE
Other - Middle Name:ULEP
Other - Last Name:LAYUGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:86-260 FARRINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-3128
Mailing Address - Country:US
Mailing Address - Phone:808-697-3433
Mailing Address - Fax:
Practice Address - Street 1:1520 LILIHA ST STE 404
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3563
Practice Address - Country:US
Practice Address - Phone:808-545-3567
Practice Address - Fax:808-545-3568
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI18287208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics