MEDICARE: ELVIS EATON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-26-543403	HI

General Provider Information

NPI Number	:	1114852563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELVIS EATON

Provider Business Mailing Address
First Line	:	944 LAWELAWE ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96821-1770
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1448 LILIHA ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96817-3589
Country	:	US
Telephone Number	:	808-681-2718
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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Directions to “ ELVIS EATON ” Practice Location

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