Provider Demographics
NPI:1396737334
Name:CHING, SHANNON Y (AUD)
Entity type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:Y
Last Name:CHING
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2010-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAUD-26237600000X
HIHA-24237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI7468620OtherUNIVERSITY HEALTH ALLIANC
HI00E0015643OtherHMSA, HMSA QUEST, TRICARE
HI520374OtherHMA, INC.
HI01466206Medicaid
HI7468620OtherUNIVERSITY HEALTH ALLIANC