Healthcare Provider Details

I. General information

NPI: 1144161829
Provider Name (Legal Business Name): MASTERS THERAPEUTIC MASSAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-1104 KAPAAHULANI ST
EWA BEACH HI
96706-3760
US

IV. Provider business mailing address

91-1104 KAPAAHULANI ST
EWA BEACH HI
96706-3760
US

V. Phone/Fax

Practice location:
  • Phone: 808-258-7501
  • Fax:
Mailing address:
  • Phone: 808-258-7501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: RONALD MASTERS
Title or Position: OWNER
Credential: MA
Phone: 808-258-7501