Healthcare Provider Details

I. General information

NPI: 1558744870
Provider Name (Legal Business Name): ALOHA ACUPUNCTURE & WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2015
Last Update Date: 07/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 HINANO ST
HILO HI
96720-4406
US

IV. Provider business mailing address

465 HINANO ST
HILO HI
96720-4406
US

V. Phone/Fax

Practice location:
  • Phone: 808-854-5063
  • Fax:
Mailing address:
  • Phone: 808-854-5063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number826
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number7262
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number13758
License Number StateHI

VIII. Authorized Official

Name: MS. JULIENNE KANESHIRO
Title or Position: ACUPUNCTURIST
Credential: LAC
Phone: 808-854-5063