Healthcare Provider Details

I. General information

NPI: 1497023485
Provider Name (Legal Business Name): TARYN AYAKO OYADOMARI OKADA LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2011
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 HARDING AVE
HONOLULU HI
96816-2412
US

IV. Provider business mailing address

3515 HARDING AVE
HONOLULU HI
96816-2412
US

V. Phone/Fax

Practice location:
  • Phone: 808-735-6981
  • Fax: 808-735-6984
Mailing address:
  • Phone: 808-735-6981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1721
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: