Healthcare Provider Details

I. General information

NPI: 1902769433
Provider Name (Legal Business Name): MRS. YANISA THONG EMPLEO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-3575 IWIKUAMOO ST UNIT 303
EWA BEACH HI
96706-6895
US

IV. Provider business mailing address

94-794 KAAHOLO ST
WAIPAHU HI
96797-1284
US

V. Phone/Fax

Practice location:
  • Phone: 808-798-7062
  • Fax:
Mailing address:
  • Phone: 808-798-7062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT-15413
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: