Healthcare Provider Details

I. General information

NPI: 1053257790
Provider Name (Legal Business Name): DEANNA PALFREY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4-356 KUHIO HWY STE 113B
KAPAA HI
96746-1413
US

IV. Provider business mailing address

4720 AKOA ST
KAPAA HI
96746-1703
US

V. Phone/Fax

Practice location:
  • Phone: 808-320-0037
  • Fax:
Mailing address:
  • Phone: 808-320-0037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number14683
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: