Provider Demographics
NPI:1457566440
Name:SIMONSEN, VALERIE LANE (ND)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:LANE
Last Name:SIMONSEN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 KAHOOKELE ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2106
Mailing Address - Country:US
Mailing Address - Phone:808-244-3844
Mailing Address - Fax:
Practice Address - Street 1:2122 KAHOOKELE ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2106
Practice Address - Country:US
Practice Address - Phone:808-244-3844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI115175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath