Healthcare Provider Details

I. General information

NPI: 1942729082
Provider Name (Legal Business Name): MRS. YUKO K OKURE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2017
Last Update Date: 09/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 S KING ST STE 212
HONOLULU HI
96814-2505
US

IV. Provider business mailing address

1413 S KING ST STE 212
HONOLULU HI
96814-2505
US

V. Phone/Fax

Practice location:
  • Phone: 808-286-6882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT-7920
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: