Waianae District Comprehensive Health and Hospital Board, Incorporated
Organization Active NPI Federally Qualified Health Center (FQHC) · Waianae, HI
NPI 1164597795 · NPPES record last updated Nov 21, 2025
Key facts
- NPI
- 1164597795
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED
- Practice address
- 86-120 Farrington Hwy
Suite C305A
Waianae, HI 96792-3000 - Phone
- (808) 697-3300
- Fax
- (808) 697-3687
- NPI assigned
- Nov 21, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED
Authorized official
- Name
- Cindy Yee
- Title
- Chief Financial Officer
- Phone
- (808) 697-3128
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 16
Corporate family (same tax ID) 38
Practitioners 161
-
Christina K.K. Adams, M.D.
-
Tiana Rose L. Ahue, PA-C
-
Razel Alibin, FNP
-
Rachel E Allen, FNP
-
Mimi Andjelic, PSYD
-
Alexander Anshus, MD
-
Kasey Arita-Nakamine, PSY.D.
-
Ashley Baldauf, D.O.
-
Argenita Balinbin, APRN-RX FNP-C
-
Laura Aline Blue, APRN
-
Shanda Brack, APRN
-
Marcin Bury, PHD
-
Markjason Tabudlo Cabudol, DNP, APRN, AGPCNP-BC
-
Stefanie K. Y. Chang-Hiu, RD, MPH
-
Kyle Chang, PSYD
-
John O Cheung, M.P.H., R.D.
-
Lena Jeong Eun Choi, DNP, APRN-RX, FNP-BC
-
Jennifer Costa, FNP-BC
-
Oakley M. Davis, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
Federally qualified health center certification: CCN 121833
- Legal name
- WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD INCORPORATED
- Doing business as
- WAIOLA CLINIC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- May 2, 2007
- Last certification
- May 2, 2007
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 6, 1969 in HI
- Enrollment address
- 86-120 Farrington Hwy
Ste C305A
Waianae, HI 96792-3072
All disclosed owners & managing parties 22
| Name | Role | Since | Share |
|---|---|---|---|
| Genevieve Aken |
Other | May 19, 2020 | |
| Dane K Lloyd |
Other | May 5, 2012 | |
| Charles Hew-Len |
Other | May 18, 2015 | |
| Clifford K Isara |
Other | Nov 15, 2007 | |
| Desire de Soto |
Other | May 21, 2024 | |
| Richard P Bettini |
W-2 Managing Employee |
Jul 1, 1993 | |
| Other | Jul 1, 1993 | ||
| Marianne Glushenko |
Other | May 21, 2024 | |
| Lajuaine C Suiso |
Other | May 5, 2012 | |
| Merrie L Aipoalani |
Other | Nov 15, 2007 | |
| Denice Keliikoa |
Other | May 18, 2015 | |
| Deroy Lavatai |
Other | May 16, 2023 | |
| Anthony Paris |
Other | Apr 20, 2021 | |
| Billie J Hauge |
Other | Mar 17, 2014 | |
| Tesha Malama |
Other | May 17, 2022 | |
| Judith Babson |
Other | May 21, 2018 | |
| Todd Nitta |
Other | Jul 25, 2023 | |
| Cindy Yee |
W-2 Managing Employee |
Nov 25, 2019 | |
| Virginia M Fuata |
Other | Nov 15, 2007 | |
| Renee J Rego |
Other | May 20, 2010 | |
| Florine D Pell |
Other | May 18, 2015 | |
| Wayne K Suehiro |
Other | Nov 15, 2007 | |
| Daniel H Gomes |
Other | Nov 15, 2007 |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| The Comp at Tamura Super Market |
Federally qualified health center | Operational/Managerial Control | May 6, 1969 |
| Makaha Health |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1972 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070216000694 | HI | Part a Provider - Federally Qualified Health Center (FQHC) | 9931008349 | Practice locations: Waianae, HI |
National Provider Directory
- Tax ID family
- Waianae Coast Comp H
- Part of
- Waianae Coast Comp H
Locations
86-120 Farrington Hwy
Ste C305A
Waianae, HI 96792
Phone (808) 697-3133
86-120 Farrington Hwy
#C305A
Waianae, HI 96792
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Non-Surgical Family Planning Clinic/Center | 261QF0050X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | |||
| Primary Care Clinic/Center | 261QP2300X | |||
| Urgent Care Clinic/Center | 261QU0200X |
Addresses
Primary practice location
86-120 Farrington Hwy
Suite C305A
Waianae, HI 96792-3000
Mailing address
86-260 Farrington Hwy
Waianae, HI 96792-3128
Phone (808) 697-3300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00934901 | Medicaid | HI |
Other names
- Waiola Clinic
Other providers in Waianae, HI
- Waianae District Comprehensive Health and Hospital Board, Incorporated
- Waianae District Comprehensive Health and Hospital Board, Incorporated
- Waianae District Comprehensive Health and Hospital Board, Incorporated
- Waianae District Comprehensive Health and Hospital Board, Incorporated
- Waianae District Comprehensive Health and Hospital Board, Incorporated
- Waianae District Comprehensive Health and Hospital Board, Incorporated
- Waianae District Comprehensive Health and Hospital Board, Incorporated
- Waianae District Comprehensive Health and Hospital Board, Incorporated
- Waianae District Comprehensive Health and Hospital Board, Incorporated
- Waianae District Comprehensive Health and Hospital Board, Incorporated
All providers in Waianae, HI · Federally Qualified Health Center (FQHC) in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.