Provider Demographics
NPI:1902504624
Name:MAKISHIMA, SHAIANNE KALENA (MA)
Entity Type:Individual
Prefix:
First Name:SHAIANNE
Middle Name:KALENA
Last Name:MAKISHIMA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4280 SALT LAKE BLVD APT G40
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-1153
Mailing Address - Country:US
Mailing Address - Phone:254-702-6668
Mailing Address - Fax:
Practice Address - Street 1:1034 QUEEN ST FL 2
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4116
Practice Address - Country:US
Practice Address - Phone:619-218-7523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor