Provider Demographics
NPI:1174965131
Name:SHIGENAGA, SHELBI
Entity type:Individual
Prefix:
First Name:SHELBI
Middle Name:
Last Name:SHIGENAGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 MIKIMIKI PL
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-1330
Mailing Address - Country:US
Mailing Address - Phone:808-969-2093
Mailing Address - Fax:
Practice Address - Street 1:234 WAIANUENUE AVENUE
Practice Address - Street 2:SUITE 215
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-935-7949
Practice Address - Fax:808-935-5996
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional