Provider Demographics
NPI:1558744169
Name:JALE, GLEN
Entity Type:Individual
Prefix:MR
First Name:GLEN
Middle Name:
Last Name:JALE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 WAIALAE AVE
Mailing Address - Street 2:SUITE 345
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5842
Mailing Address - Country:US
Mailing Address - Phone:808-732-5223
Mailing Address - Fax:
Practice Address - Street 1:3221 WAIALAE AVE
Practice Address - Street 2:SUITE 345
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5842
Practice Address - Country:US
Practice Address - Phone:808-732-5223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI102237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist