Provider Demographics
NPI:1598797409
Name:SHIGEMURA, RENAE HOONG LAN (ATC)
Entity type:Individual
Prefix:MISS
First Name:RENAE
Middle Name:HOONG LAN
Last Name:SHIGEMURA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:98-1921 WILOU ST
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-1663
Mailing Address - Country:US
Mailing Address - Phone:808-487-5306
Mailing Address - Fax:808-956-5717
Practice Address - Street 1:1337 LOWER CAMPUS RD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-2312
Practice Address - Country:US
Practice Address - Phone:808-956-7144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer