Provider Demographics
NPI:1649227026
Name:CHRISTENSEN, EMBER A (DO)
Entity Type:Individual
Prefix:DR
First Name:EMBER
Middle Name:A
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55-220 KULANUI ST. #1728
Mailing Address - Street 2:
Mailing Address - City:LALE
Mailing Address - State:HI
Mailing Address - Zip Code:96762-1293
Mailing Address - Country:US
Mailing Address - Phone:808-675-3510
Mailing Address - Fax:808-675-3506
Practice Address - Street 1:55-220 KULANUI ST. #1728
Practice Address - Street 2:
Practice Address - City:LALE
Practice Address - State:HI
Practice Address - Zip Code:96762-1293
Practice Address - Country:US
Practice Address - Phone:808-675-3510
Practice Address - Fax:808-675-3506
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001790207P00000X, 207Q00000X
HIDOS-1780207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H25145Medicare UPIN