Healthcare Provider Details

I. General information

NPI: 1275636599
Provider Name (Legal Business Name): DEANE MICHIKO CHINEN P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEANE CHINEN MAYESHITO P.T.

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 N KUAKINI STREET SUITE 1101
HONOLULU HI
96817
US

IV. Provider business mailing address

405 N KUAKINI STREET SUITE 1101
HONOLULU HI
96817
US

V. Phone/Fax

Practice location:
  • Phone: 808-536-3072
  • Fax: 808-536-5082
Mailing address:
  • Phone: 808-536-3072
  • Fax: 808-536-5082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1603
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-1603
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: