| Pacific Wellness, Llc | |
|
401 Kamakee St Suite 417 Honolulu HI 96814-4203 | |
| (808) 372-1952 | |
| Not Available |
| Full Name | Pacific Wellness, Llc |
|---|---|
| Speciality | Counselor |
| Location | 401 Kamakee St, Honolulu, Hawaii |
| Authorized Official Name and Position | Melissa Hogan (MEMBER) |
| Authorized Official Contact | 8083721952 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Wellness, Llc 401 Kamakee St Suite 417 Honolulu HI 96814-4203 Ph: (808) 372-1952 | Pacific Wellness, Llc 401 Kamakee St Suite 417 Honolulu HI 96814-4203 Ph: (808) 372-1952 |
| NPI Number | 1922415280 |
|---|---|
| Provider Enumeration Date | 07/18/2014 |
| Last Update Date | 12/09/2014 |
| Medicare PECOS PAC ID | 1557714029 |
|---|---|
| Medicare Enrollment ID | O20240131003458 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922415280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 321 (Hawaii) | Primary |
| Provider Name | Melissa A Hogan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922444843 PECOS PAC ID: 2466805932 Enrollment ID: I20240131003560 |
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