Provider Demographics
NPI:1609382340
Name:WELLNESS PARTNERS HAWAII INC
Entity Type:Organization
Organization Name:WELLNESS PARTNERS HAWAII INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KUO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:808-379-6656
Mailing Address - Street 1:PO BOX 26062
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-6062
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6700 KALANIANAOLE HWY STE 201
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1279
Practice Address - Country:US
Practice Address - Phone:808-379-6656
Practice Address - Fax:808-379-3750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-18
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1741363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty