Healthcare Provider Details

I. General information

NPI: 1669394128
Provider Name (Legal Business Name): MORGAN ELLEN GRAVES TRIMBLE OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HALA DR
HONOLULU HI
96817-2157
US

IV. Provider business mailing address

91-1059 PUANIU ST APT 21C
EWA BEACH HI
96706-2177
US

V. Phone/Fax

Practice location:
  • Phone: 808-475-1225
  • Fax: 808-452-1109
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-2785
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: