Healthcare Provider Details
I. General information
NPI: 1689979734
Provider Name (Legal Business Name): JULEE PORTNER SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/21/2011
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3150 MONSARRAT AVE STE 200
HONOLULU HI
96815-4488
US
IV. Provider business mailing address
3150 MONSARRAT AVE STE 200
HONOLULU HI
96815-4488
US
V. Phone/Fax
- Phone: 808-735-4451
- Fax:
- Phone: 808-735-5541
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 16491 |
| License Number State | HI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174N00000X |
| Taxonomy | Lactation Consultant (Non-RN) |
| License Number | L042287 |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174H00000X |
| Taxonomy | Health Educator |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | SP-505 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: