Individual
CHASEN DAUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1401 S BERETANIA ST STE 102, HONOLULU, HI 96814-1871
(808) 356-5699
Mailing address
1401 S BERETANIA ST STE 102, HONOLULU, HI 96814-1871
(808) 356-5699
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
AMD-1049
HI
207X00000X
Orthopaedic Surgery Physician
LKJ
HI
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AMD-1049
STATE OF HAWAII
HI
Enumeration date
12/04/2020
Last updated
11/17/2021
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