Individual
MRS. JESSICA SAGE BLANK MENDONSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2120 KAOHU ST, WAILUKU, HI 96793-2205
(808) 377-4734
(808) 377-4734
Mailing address
2120 KAOHU ST, WAILUKU, HI 96793-2205
(808) 377-4734
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
363A00000X
Physician Assistant
Primary
AMD588
HI
363A00000X
Physician Assistant
—
WA
Other
Enumeration date
11/14/2013
Last updated
01/27/2022
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