Provider Demographics
NPI:1932873437
Name:CHAN, KATHARINE WOA-LY
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:WOA-LY
Last Name:CHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 MAIKA ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-5436
Mailing Address - Country:US
Mailing Address - Phone:808-280-8595
Mailing Address - Fax:
Practice Address - Street 1:468 MAIKA ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-5436
Practice Address - Country:US
Practice Address - Phone:808-280-8595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health