Provider Demographics
NPI:1356838874
Name:SALSE, DEANNA LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:LYNN
Last Name:SALSE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 E KAAHUMANU AVE
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2176
Mailing Address - Country:US
Mailing Address - Phone:808-877-0068
Mailing Address - Fax:808-877-3607
Practice Address - Street 1:70 E KAAHUMANU AVE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2176
Practice Address - Country:US
Practice Address - Phone:808-877-0068
Practice Address - Fax:808-877-3607
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist