Provider Demographics
NPI:1184810558
Name:ALLISON, RENEE DEANNA (OD)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:DEANNA
Last Name:ALLISON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 LAUKAHI ST.
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821
Mailing Address - Country:US
Mailing Address - Phone:808-230-3548
Mailing Address - Fax:808-951-0320
Practice Address - Street 1:1712 LILIHA ST
Practice Address - Street 2:SUITE 400
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-524-1010
Practice Address - Fax:808-949-4915
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI623T152W00000X
HI623152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist