Healthcare Provider Details

I. General information

NPI: 1629196050
Provider Name (Legal Business Name): LENA OSTERLUND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 MILILANI ST STE 702A
HONOLULU HI
96813-2924
US

IV. Provider business mailing address

1451 S KING ST STE 506
HONOLULU HI
96814-2506
US

V. Phone/Fax

Practice location:
  • Phone: 808-523-9363
  • Fax: 808-523-9418
Mailing address:
  • Phone: 808-955-5560
  • Fax: 808-955-5580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 1019
License Number StateHI

VIII. Authorized Official

Name: LENA OSTERLUND
Title or Position: OWNER
Credential: PT
Phone: 808-955-5560