Individual
AMANDA MARKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2180 MAIN ST, WAILUKU, HI 96793-1625
(808) 242-6464
(808) 242-4209
Mailing address
2180 MAIN ST, WAILUKU, HI 96793-1625
(808) 242-6464
(808) 242-4209
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
AMD464
HI
363A00000X
Physician Assistant
PA60062946
WA
363AM0700X
Medical Physician Assistant
PA60062946
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AMD-464
HI LIC
HI
Enumeration date
12/23/2008
Last updated
01/09/2015
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