Provider Demographics
NPI:1821026618
Name:SIMPSON, DAWANA MARIA (DC)
Entity Type:Individual
Prefix:
First Name:DAWANA
Middle Name:MARIA
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59-237 KANALOA WAY
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8590
Mailing Address - Country:US
Mailing Address - Phone:808-450-2849
Mailing Address - Fax:
Practice Address - Street 1:59-237 KANALOA WAY
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8590
Practice Address - Country:US
Practice Address - Phone:808-557-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5461111N00000X
CA23694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC236940Medicare ID - Type Unspecified
AZ28813Medicare ID - Type Unspecified
AZU65849Medicare UPIN