Individual
ETHAN TOMAS CHACO GARRIDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 KAMOKILA BLVD STE 210, KAPOLEI, HI 96707-2096
(808) 591-6060
Mailing address
92-1388 PUNAWAINUI ST, KAPOLEI, HI 96707-2825
(808) 348-7933
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
HI
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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