Provider Demographics
NPI:1346362886
Name:KAGAWA, WENDY (PHARMD, CGP)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:KAGAWA
Suffix:
Gender:F
Credentials:PHARMD, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1877 HALE O LANI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-5907
Mailing Address - Country:US
Mailing Address - Phone:808-937-8386
Mailing Address - Fax:
Practice Address - Street 1:688 KINOOLE ST
Practice Address - Street 2:STE 109
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3877
Practice Address - Country:US
Practice Address - Phone:808-217-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0010920183500000X
HIPH26831835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No183500000XPharmacy Service ProvidersPharmacist