Provider Demographics
NPI:1174052732
Name:DYE, ANNE DERICKS (ND)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:DERICKS
Last Name:DYE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1188 BISHOP ST STE 1509
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3306
Mailing Address - Country:US
Mailing Address - Phone:808-783-0361
Mailing Address - Fax:808-792-3336
Practice Address - Street 1:1188 BISHOP ST STE 1509
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3306
Practice Address - Country:US
Practice Address - Phone:808-783-0361
Practice Address - Fax:808-792-3336
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR59256175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath