Provider Demographics
NPI:1033093174
Name:MANGAUIL-D'AMORE, SHALYN
Entity type:Individual
Prefix:
First Name:SHALYN
Middle Name:
Last Name:MANGAUIL-D'AMORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 KILAUEA AVE
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3089
Mailing Address - Country:US
Mailing Address - Phone:808-934-3284
Mailing Address - Fax:
Practice Address - Street 1:15-2866 PAHOA VILLAGE RD BLDG C
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-7720
Practice Address - Country:US
Practice Address - Phone:808-934-3284
Practice Address - Fax:808-229-1410
Is Sole Proprietor?:No
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator