Provider Demographics
NPI:1508927153
Name:AMOUYAL, SHANA LOUANN (DC)
Entity Type:Individual
Prefix:DR
First Name:SHANA
Middle Name:LOUANN
Last Name:AMOUYAL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 KULI PUU ST
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7158
Mailing Address - Country:US
Mailing Address - Phone:808-283-0097
Mailing Address - Fax:
Practice Address - Street 1:95 E LIPOA ST STE A206
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8193
Practice Address - Country:US
Practice Address - Phone:808-283-0097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI979111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI000250654OtherHMSA
HI100745Medicare ID - Type Unspecified