Healthcare Provider Details

I. General information

NPI: 1740114628
Provider Name (Legal Business Name): SIRIYAPORN CALHOUN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 S KING ST STE 339
HONOLULU HI
96814-2604
US

IV. Provider business mailing address

501 HAHAIONE ST APT 10G
HONOLULU HI
96825-1426
US

V. Phone/Fax

Practice location:
  • Phone: 808-466-9946
  • Fax:
Mailing address:
  • Phone: 808-466-9946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT16219
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: