Provider Demographics
NPI:1437447547
Name:GANDRE, ALLISON KAY (ND)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:KAY
Last Name:GANDRE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:ALLISON
Other - Middle Name:GANDRE
Other - Last Name:HOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:1144 KOKO HEAD AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816
Mailing Address - Country:US
Mailing Address - Phone:808-421-7753
Mailing Address - Fax:808-735-5505
Practice Address - Street 1:407 ULUNIU ST STE 412
Practice Address - Street 2:KAILUA MEDICAL ARTS BLDG
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734
Practice Address - Country:US
Practice Address - Phone:808-421-7753
Practice Address - Fax:808-230-2476
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIND 221175F00000X
WANT00001639175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath