Healthcare Provider Details

I. General information

NPI: 1043497100
Provider Name (Legal Business Name): JAIME NORIKO KUAMO'O PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAIME NORIKO KAWAGUCHI PT

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 05/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 WAIALAE AVE SUITE 205
HONOLULU HI
96816-3257
US

IV. Provider business mailing address

1070 AWAWAMALU ST APT C
HONOLULU HI
96825-2615
US

V. Phone/Fax

Practice location:
  • Phone: 808-732-2500
  • Fax: 808-732-2501
Mailing address:
  • Phone: 808-729-4419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number29396
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3015
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: