Healthcare Provider Details

I. General information

NPI: 1386557692
Provider Name (Legal Business Name): MATTHEW FORBY MASSAGE THERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 WAIMANU ST
HONOLULU HI
96814-3411
US

IV. Provider business mailing address

1025 WAIMANU ST APT 314
HONOLULU HI
96814-3428
US

V. Phone/Fax

Practice location:
  • Phone: 808-780-1024
  • Fax:
Mailing address:
  • Phone: 808-780-1024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT-15209
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: