Provider Demographics
NPI:1720003825
Name:GUTHRIE, SHAYNE M (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAYNE
Middle Name:M
Last Name:GUTHRIE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47-220 HUI AEKO WAY
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744
Mailing Address - Country:US
Mailing Address - Phone:808-372-2273
Mailing Address - Fax:808-445-9110
Practice Address - Street 1:47-220 HUI AEKO WAY
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744
Practice Address - Country:US
Practice Address - Phone:808-445-9100
Practice Address - Fax:808-445-9110
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI805111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH52246OtherGROUP BOX 33
HIU78222Medicare UPIN