Provider Demographics
NPI:1366107294
Name:ISHIKAWA, KYREN (PHARMD)
Entity type:Individual
Prefix:
First Name:KYREN
Middle Name:
Last Name:ISHIKAWA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2869 PUA LOKE ST
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1656
Mailing Address - Country:US
Mailing Address - Phone:808-652-7801
Mailing Address - Fax:
Practice Address - Street 1:4491A KOLOPA ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-2034
Practice Address - Country:US
Practice Address - Phone:808-246-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-4603183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist