Provider Demographics
NPI:1861000119
Name:SHINDO, MYRA H (MS)
Entity Type:Individual
Prefix:
First Name:MYRA
Middle Name:H
Last Name:SHINDO
Suffix:
Gender:F
Credentials:MS
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 884
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-0884
Mailing Address - Country:US
Mailing Address - Phone:808-255-8759
Mailing Address - Fax:
Practice Address - Street 1:134 WALKER AVE
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-1817
Practice Address - Country:US
Practice Address - Phone:808-255-8759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health