Provider Demographics
NPI:1659893980
Name:MORDUE, LAUREN (OD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:MORDUE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:573 KAILUA RD STE 106
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2836
Mailing Address - Country:US
Mailing Address - Phone:808-501-2020
Mailing Address - Fax:808-501-2015
Practice Address - Street 1:573 KAILUA RD STE 106
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2836
Practice Address - Country:US
Practice Address - Phone:808-501-2020
Practice Address - Fax:808-501-2015
Is Sole Proprietor?:No
Enumeration Date:2017-07-07
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOD-859152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist