Basic Information
| Provider Information | |||||||||
| NPI: | 1225387459 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TANIGUCHI | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | DUONG | ||||||||
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| Credential: | AU. D | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | DUONG | ||||||||
| OtherFirstName: | LISA | ||||||||
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| OtherCredential: | AU.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 677 ALA MOANA BLVD | ||||||||
| Address2: | SUITE 625 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968135419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086921583 | ||||||||
| FaxNumber: | 8085666292 | ||||||||
| Practice Location | |||||||||
| Address1: | 677 ALA MOANA BLVD | ||||||||
| Address2: | SUITE 625 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968135419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8086921583 | ||||||||
| FaxNumber: | 8085666292 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2012 | ||||||||
| LastUpdateDate: | 03/20/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AY1757 | FL | N | Speech, Language and Hearing Service Providers | Audiologist | 231H00000X | LD60464380 | WA | N | Speech, Language and Hearing Service Providers | Audiologist | 231H00000X | 172 | HI | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.