Provider Demographics
NPI:1174395586
Name:LEWIS, SARAH (RD, LD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-501 MEHEUHEU PL
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-5820
Mailing Address - Country:US
Mailing Address - Phone:808-429-8754
Mailing Address - Fax:
Practice Address - Street 1:94-501 MEHEUHEU PL
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-5820
Practice Address - Country:US
Practice Address - Phone:808-429-8754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI381-LD133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered