Individual
SHANNON RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1120A MAKAWAO AVE, MAKAWAO, HI 96768-9448
(808) 573-2222
(808) 829-3673
Mailing address
64-1032 MAMALAHOA HWY, STE 306, KAMUELA, HI 96743-8441
(808) 969-1427
(808) 961-4795
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
AMD221
HI
Other
Enumeration date
05/12/2006
Last updated
08/10/2016
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