Provider Demographics
NPI:1699353730
Name:MURATA, MICHELLE HANAKO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:HANAKO
Last Name:MURATA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1348
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-1348
Mailing Address - Country:US
Mailing Address - Phone:808-476-4545
Mailing Address - Fax:
Practice Address - Street 1:1221 KAPIOLANI BLVD STE 211
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3506
Practice Address - Country:US
Practice Address - Phone:808-476-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
HIPSY-2009-0103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program