Provider Demographics
NPI:1538212618
Name:AUTELE, TABITHA THERESA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TABITHA
Middle Name:THERESA
Last Name:AUTELE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 ALAKAWA ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-5700
Mailing Address - Country:US
Mailing Address - Phone:808-432-5533
Mailing Address - Fax:
Practice Address - Street 1:501 ALAKAWA ST
Practice Address - Street 2:SUITE 101
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5700
Practice Address - Country:US
Practice Address - Phone:808-432-5533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH-2040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist