Provider Demographics
NPI:1184750754
Name:HOWARD, WENDY MARIE MEDEIROS (OTR, CHT)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:MARIE MEDEIROS
Last Name:HOWARD
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 RICHARDS ST
Mailing Address - Street 2:SUITE 903
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4605
Mailing Address - Country:US
Mailing Address - Phone:808-263-8180
Mailing Address - Fax:808-441-1900
Practice Address - Street 1:700 RICHARDS ST
Practice Address - Street 2:SUITE 903
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4605
Practice Address - Country:US
Practice Address - Phone:808-263-8180
Practice Address - Fax:808-441-1900
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHI 488225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIHI 488OtherSTATE REGISTRATION
HIH56616Medicare ID - Type UnspecifiedCORRECT MEDICARE ID
HIP66474Medicare UPIN