Provider Demographics
NPI:1487039442
Name:MOMOHARA-KANETANI, CHRISTIE-BRIANNA K (CGC, MS)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIE-BRIANNA
Middle Name:K
Last Name:MOMOHARA-KANETANI
Suffix:
Gender:F
Credentials:CGC, MS
Other - Prefix:MISS
Other - First Name:CHRISTIE
Other - Middle Name:
Other - Last Name:MOMOHARA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:2828 PAA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4430
Mailing Address - Country:US
Mailing Address - Phone:808-432-5777
Mailing Address - Fax:
Practice Address - Street 1:2828 PAA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4430
Practice Address - Country:US
Practice Address - Phone:808-432-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAGP60583599170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS