MEDICARE: ADVANCED MASSAGE INC.

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	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1164378956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED MASSAGE INC.

Provider Business Mailing Address
First Line	:	91-1045 NIOLO ST
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-5118
Country	:	US
Telephone Number	:	808-729-8391
Fax Number	:	808-762-0490

Provider Business Practice Location Address
First Line	:	91-1037 PUUAINAKO PL
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-4721
Country	:	US
Telephone Number	:	808-729-8391
Fax Number	:	808-762-0490

Authorized Official
Title or Position	:	CEO
Name	:	SAMANTHA TANJOCO
Credential	:	LMT
Telephone Number	:	808-729-8391

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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