Individual
JASON LEE RIESSLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
94-450 MOKUOLA STREET, SUITE 100, WAIPAHU, HI 96797
(808) 854-4275
Mailing address
475 KINOOLE ST STE 102, HILO, HI 96720-2900
(808) 854-4275
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN-18625
HI
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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