Provider Demographics
NPI:1326388844
Name:PADWICK, MATTHEW (RN)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:PADWICK
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 PIIKOI ST APT 401
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1126
Mailing Address - Country:US
Mailing Address - Phone:808-691-4221
Mailing Address - Fax:808-691-7896
Practice Address - Street 1:1301 PUNCHBOWL ST
Practice Address - Street 2:FAMILY TREATMENT CENTER
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2402
Practice Address - Country:US
Practice Address - Phone:808-691-4221
Practice Address - Fax:808-699-7896
Is Sole Proprietor?:No
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHI52611163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent