Healthcare Provider Details

I. General information

NPI: 1578123493
Provider Name (Legal Business Name): MRS. RACHEL CHRISTINE MANUEL ESCANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 07/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2459 10TH AVE
HONOLULU HI
96816-3051
US

IV. Provider business mailing address

2459 10TH AVE
HONOLULU HI
96816-3051
US

V. Phone/Fax

Practice location:
  • Phone: 808-564-5217
  • Fax:
Mailing address:
  • Phone: 808-564-5217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: