Healthcare Provider Details

I. General information

NPI: 1831001007
Provider Name (Legal Business Name): JONELL PAHUKULA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2047 W WOLFENSBERGER RD # 303
CASTLE ROCK CO
80109-9651
US

IV. Provider business mailing address

1128 RACINE ST
AURORA CO
80011-6326
US

V. Phone/Fax

Practice location:
  • Phone: 303-505-9313
  • Fax:
Mailing address:
  • Phone: 808-489-0952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT.0027031
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: