Provider Demographics
NPI:1568911139
Name:WU, PATRICK HON-YIN (RD)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:HON-YIN
Last Name:WU
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2256 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-3636
Mailing Address - Country:US
Mailing Address - Phone:808-741-0421
Mailing Address - Fax:
Practice Address - Street 1:2256 WILSON ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-3636
Practice Address - Country:US
Practice Address - Phone:808-741-0421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI86066255133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered