Healthcare Provider Details

I. General information

NPI: 1881507614
Provider Name (Legal Business Name): JARED DAVIS PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 S KING ST STE 300
HONOLULU HI
96814-2066
US

IV. Provider business mailing address

3321 LOWER RD
HONOLULU HI
96822-1460
US

V. Phone/Fax

Practice location:
  • Phone: 808-348-6336
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-6486
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: