Provider Demographics
NPI:1528498839
Name:SASAKI, SHIHO NAKANO
Entity type:Individual
Prefix:
First Name:SHIHO
Middle Name:NAKANO
Last Name:SASAKI
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 1:642 ULUKAHIKI ST STE 100
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4418
Mailing Address - Country:US
Mailing Address - Phone:808-263-4665
Mailing Address - Fax:808-263-4718
Practice Address - Street 1:642 ULUKAHIKI ST STE 100
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4418
Practice Address - Country:US
Practice Address - Phone:808-263-4665
Practice Address - Fax:808-263-4718
Is Sole Proprietor?:No
Enumeration Date:2013-11-22
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily