Provider Demographics
NPI:1023894383
Name:JANG, SIRIPORN JENJAI (LAC, DAC)
Entity type:Individual
Prefix:DR
First Name:SIRIPORN
Middle Name:JENJAI
Last Name:JANG
Suffix:
Gender:F
Credentials:LAC, DAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 KAPIOLANI BLVD STE 601
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3897
Mailing Address - Country:US
Mailing Address - Phone:808-947-7582
Mailing Address - Fax:808-947-7583
Practice Address - Street 1:1600 KAPIOLANI BLVD STE 601
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3897
Practice Address - Country:US
Practice Address - Phone:808-947-7582
Practice Address - Fax:808-947-7583
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-1422171100000X
HIMAT-16094225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist