Healthcare Provider Details

I. General information

NPI: 1174393474
Provider Name (Legal Business Name): HITOMI OTAGIRI ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2824 KIHEI PL APT B
HONOLULU HI
96816-1321
US

IV. Provider business mailing address

7023 N 84TH AVE
GLENDALE AZ
85305-6994
US

V. Phone/Fax

Practice location:
  • Phone: 808-266-0752
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND-368-0
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number24-1834
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: