Colleen M Ichiyama-kong (NPI# 1881631422, PAC ID# 8022909357) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1881631422 |
| PAC ID by PECOS | 8022909357 |
| Professional Enrollment ID | I20050824000875 |
| Full Name | Colleen M Ichiyama-kong |
| Address |
2049 Wells St Suite 1 Wailuku HI 96793-2239 |
| Gender | F |
| Credential | OD |
| Medical School | PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY |
| Graduation Year | 1997 |
| Primary Specialty | OPTOMETRY |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 2049 Wells St, Suite 1, Wailuku, HI 96793-2239 |
| Street Address |
2049 WELLS ST SUITE 1 |
| City | WAILUKU |
| State | HI |
| Zip | 96793-2239 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Soren Carlsen | Urology | 1883 Mill St, Wailuku, HI 96793-1236 | |
| Robert D Lanser Jr. | Clinical Social Worker | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| David J Wittenberg | Psychologist, Clinical | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Bahram Taghavi | Psychiatry | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Margaret E Goldberg | Clinical Social Worker | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| George L Carlson | Addiction Medicine | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Connie J Debord | Clinical Social Worker | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Joel Tapler | Clinical Social Worker | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Royal Randolph Jr. | Psychiatry | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Sharilyn Jane Butteling | Nurse Practitioner | Aloha House, Inc. | 1787 Wili Pa Loop, Suite 7, Wailuku, HI 96793-1271 |
| Find all physicians in zip 96793 | |||
| City | WAILUKU |
| Zip Code | 96793 |
| Specialty | OPTOMETRY |
| City + Specialty | WAILUKU + OPTOMETRY |
Please comment or provide details below to improve the information on Colleen M Ichiyama-kong.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.