Active NPI
Jackie Liu
- Medical Physician Assistant
- Mililani, HI
National Provider Identifier
1386436087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- AMD-1518
- Practice address
- 100 Kahelu Ave Ste 226
Mililani, HI 96789-3962 - Phone
- (808) 621-1000
- NPI assigned
- May 19, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | AMD-1518 | HI | Primary |
Addresses
Primary practice location
100 Kahelu Ave Ste 226
Mililani, HI 96789-3962
Mailing address
100 Kahelu Ave Ste 226
Mililani, HI 96789-3962
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789084800000",
"number": "1386436087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 KAHELU AVE STE 226",
"city": "MILILANI",
"state": "HI",
"postal_code": "967893962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 KAHELU AVE STE 226",
"city": "MILILANI",
"state": "HI",
"postal_code": "967893962",
"telephone_number": "808-621-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIU",
"first_name": "JACKIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-19",
"last_updated": "2026-09-11",
"certification_date": "2026-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant, Medical",
"state": "HI",
"license": "AMD-1518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mililani, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.