Provider Demographics
NPI:1336195940
Name:HAWAII PROFESSIONAL AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:HAWAII PROFESSIONAL AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CHING
Authorized Official - Suffix:
Authorized Official - Credentials:MSPA, CCC-A
Authorized Official - Phone:808-597-1877
Mailing Address - Street 1:1010 S KING ST
Mailing Address - Street 2:SUITE 802
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1701
Mailing Address - Country:US
Mailing Address - Phone:808-597-1877
Mailing Address - Fax:808-597-1195
Practice Address - Street 1:1010 S KING ST
Practice Address - Street 2:SUITE 802
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1701
Practice Address - Country:US
Practice Address - Phone:808-597-1877
Practice Address - Fax:808-597-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI100427Medicare ID - Type Unspecified