Individual
MARY L ICHIYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, RN, CDE
Contact information
Practice address
1301 PUNCHBOWL ST, HONOLULU, HI 96813-2402
(808) 547-4823
(808) 585-5399
Mailing address
1301 PUNCHBOWL ST, HONOLULU, HI 96813-2402
(808) 547-4823
(808) 585-5399
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
APRN 344
HI
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN 17592
HI
Other
Enumeration date
12/21/2006
Last updated
07/08/2007
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