Provider Demographics
NPI:1023419660
Name:SHISHIDO, HANAKO (PHD)
Entity type:Individual
Prefix:DR
First Name:HANAKO
Middle Name:
Last Name:SHISHIDO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:HANAKO
Other - Middle Name:
Other - Last Name:MURASE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:COLORADO STATE UNIVERSITY
Mailing Address - Street 2:AYLESWORTH HALL, NE WING
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80523-8010
Mailing Address - Country:US
Mailing Address - Phone:970-491-1740
Mailing Address - Fax:
Practice Address - Street 1:COLORADO STATE UNIVERSITY
Practice Address - Street 2:AYLESWORTH HALL, NE WING
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80523-8010
Practice Address - Country:US
Practice Address - Phone:970-491-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program