Healthcare Provider Details

I. General information

NPI: 1174868939
Provider Name (Legal Business Name): CARLY ARAKAWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2012
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1677 PENSACOLA ST
HONOLULU HI
96822-2676
US

IV. Provider business mailing address

PO BOX 11813
HONOLULU HI
96828-0813
US

V. Phone/Fax

Practice location:
  • Phone: 808-537-3371
  • Fax:
Mailing address:
  • Phone: 808-265-6958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number174
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: