Provider Demographics
NPI:1215529318
Name:HENCKEL, VALERIE NAOKO
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:NAOKO
Last Name:HENCKEL
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:PO BOX 2226
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-2226
Mailing Address - Country:US
Mailing Address - Phone:808-895-2273
Mailing Address - Fax:
Practice Address - Street 1:65-1158 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8442
Practice Address - Country:US
Practice Address - Phone:808-885-0033
Practice Address - Fax:808-885-0397
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH2013183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist