Jaeckle, Walter R.

Jaeckle, Walter R. is an individual health care provider with primary practice located at 65-1235 Opelo Rd Suite 1, Kamuela HI 96743-8454. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Jaeckle, Walter R. can be contacted via phone (808) 885-1045.

Contact Information

Primary practice address
65-1235 Opelo Rd Suite 1 Kamuela HI 96743-8454
Phone: (808) 885-1045
Fax: (808) 885-1045
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY 116 Hawaii

Profile Details

NPI number 1861445413
LBN Legal business name Jaeckle, Walter R.
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861445413 NPPES
Hawaii MEDICAID 00402265

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