Provider Demographics
NPI:1992382964
Name:BIHIS, TIFFANY ALICIA VALLESTEROS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:ALICIA VALLESTEROS
Last Name:BIHIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 QUEEN ST APT 906
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4195
Mailing Address - Country:US
Mailing Address - Phone:808-366-1900
Mailing Address - Fax:
Practice Address - Street 1:94-449 AKOKI ST STE 102
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2732
Practice Address - Country:US
Practice Address - Phone:808-671-5511
Practice Address - Fax:808-671-5522
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-4618183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist