Provider Demographics
NPI:1619184447
Name:WONG, CLARA J (LAC)
Entity Type:Individual
Prefix:DR
First Name:CLARA
Middle Name:J
Last Name:WONG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:PO BOX 37241
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96837-0241
Mailing Address - Country:US
Mailing Address - Phone:808-524-8837
Mailing Address - Fax:808-531-2380
Practice Address - Street 1:1188 BISHOP ST
Practice Address - Street 2:#2402
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3301
Practice Address - Country:US
Practice Address - Phone:808-524-8837
Practice Address - Fax:808-531-2380
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU -- 322171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist