Individual
MRS. DOMINIQUE VALENCIA BOLOSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 KIOPAA PL, MAKAWAO, HI 96768-8282
(808) 573-9300
(808) 573-9309
Mailing address
142 IKEA PL, MAKAWAO, HI 96768-8716
(808) 276-9188
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
IR60240637
WA
183500000X
Pharmacist
Primary
PH-3884
HI
Other
Enumeration date
04/20/2012
Last updated
02/18/2020
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