Provider Demographics
NPI:1477156677
Name:NATIONAL KIDNEY FOUNDATION OF HAWAII
Entity Type:Organization
Organization Name:NATIONAL KIDNEY FOUNDATION OF HAWAII
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE & OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HATAOKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-589-5968
Mailing Address - Street 1:1314 S KING ST STE 1555
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2073
Mailing Address - Country:US
Mailing Address - Phone:808-593-1515
Mailing Address - Fax:
Practice Address - Street 1:1314 S KING ST STE 1555
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2073
Practice Address - Country:US
Practice Address - Phone:808-593-1515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL KIDNEY FOUNDATION OF HAWAII
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1619342573OtherINDEPENDENT REGISTRATION