Individual
SHAWNA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
68-1845 WAIKOLOA RD, 201, WAIKOLOA, HI 96738-5584
(808) 345-3225
Mailing address
PO BOX 1632, KEALAKEKUA, HI 96750-1632
(808) 345-3225
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14188
HI
Other
Enumeration date
07/08/2016
Last updated
07/08/2016
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