Provider Demographics
NPI:1588663454
Name:PIEN, ETHAN (MD)
Entity Type:Individual
Prefix:
First Name:ETHAN
Middle Name:
Last Name:PIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 S KING ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1701
Mailing Address - Country:US
Mailing Address - Phone:808-597-8765
Mailing Address - Fax:808-597-6578
Practice Address - Street 1:1010 S KING ST
Practice Address - Street 2:SUITE 111
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1701
Practice Address - Country:US
Practice Address - Phone:808-597-8765
Practice Address - Fax:808-597-6578
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA850322084P0800X
HI140172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry