Provider Demographics
NPI:1700323821
Name:KWAN, CARIE (DC)
Entity Type:Individual
Prefix:
First Name:CARIE
Middle Name:
Last Name:KWAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2166
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-8166
Mailing Address - Country:US
Mailing Address - Phone:510-882-7645
Mailing Address - Fax:808-400-6007
Practice Address - Street 1:98-1256 KAAHUMANU ST STE E203
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-3282
Practice Address - Country:US
Practice Address - Phone:808-688-7362
Practice Address - Fax:800-400-6007
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC1359111N00000X
HI1359111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor