Provider Demographics
NPI:1497471882
Name:HENRICKSON, WHITNEY LEA (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:LEA
Last Name:HENRICKSON
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 KAPAHULU AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1497
Mailing Address - Country:US
Mailing Address - Phone:808-733-2600
Mailing Address - Fax:
Practice Address - Street 1:888 KAPAHULU AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1497
Practice Address - Country:US
Practice Address - Phone:808-733-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4829183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist