Provider Demographics
NPI:1942516950
Name:STOKER, COLLEEN L (LMT)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:L
Last Name:STOKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501A KAWELO RD
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-5929
Mailing Address - Country:US
Mailing Address - Phone:808-269-2694
Mailing Address - Fax:
Practice Address - Street 1:501-A KAWELO RD
Practice Address - Street 2:
Practice Address - City:HAIKU
Practice Address - State:HI
Practice Address - Zip Code:96708-5929
Practice Address - Country:US
Practice Address - Phone:808-269-2694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT 3322171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor