Healthcare Provider Details

I. General information

NPI: 1285746388
Provider Name (Legal Business Name): THOMAS IWASHITA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46-001 KAMEHAMEHA HWY SUITE 310
KANEOHE HI
96744-3711
US

IV. Provider business mailing address

94-1122 KEPAKEPA ST
WAIPAHU HI
96797-4239
US

V. Phone/Fax

Practice location:
  • Phone: 808-247-7997
  • Fax:
Mailing address:
  • Phone: 808-671-7188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-492
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5539
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: