Provider Demographics
NPI:1407037674
Name:RAMSTACK, MICHELLE S (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:S
Last Name:RAMSTACK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:770 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 705
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5212
Mailing Address - Country:US
Mailing Address - Phone:808-597-8799
Mailing Address - Fax:
Practice Address - Street 1:10625 W NORTH AVE
Practice Address - Street 2:102
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-2315
Practice Address - Country:US
Practice Address - Phone:414-877-5350
Practice Address - Fax:414-877-5360
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2017-04-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI2220363A00000X
HIAMD-564363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant