Healthcare Provider Details

I. General information

NPI: 1831022581
Provider Name (Legal Business Name): MICHELLE NAKANISHI SARAE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4348 WAIALAE AVE
HONOLULU HI
96816-5767
US

IV. Provider business mailing address

1977 HOOKUMU PL
PEARL CITY HI
96782-1767
US

V. Phone/Fax

Practice location:
  • Phone: 808-321-7135
  • Fax:
Mailing address:
  • Phone: 808-321-7135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT-8948
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: