MEDICARE: LENE MAIAVA

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	MT-29626	AZ

General Provider Information

NPI Number	:	1205769973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LENE MAIAVA

Provider Business Mailing Address
First Line	:	4181 E 24TH ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-5660
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	P.O. BOX 2287
Second Line	:
City	:	PAGO PAGO
State	:	AMERICAN SAMOA
Zip	:	96799
Country	:	UM
Telephone Number	:
Fax Number	:

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

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ LENE MAIAVA ” Practice Location

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