Healthcare Provider Details

I. General information

NPI: 1306758263
Provider Name (Legal Business Name): DIERDREE HOOKE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54-3885 AKONI PULE HWY UNIT 105B
KAPAAU HI
96755-3082
US

IV. Provider business mailing address

61-4136 KALOOLOO DR
KAMUELA HI
96743-9713
US

V. Phone/Fax

Practice location:
  • Phone: 808-825-8981
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT-17868
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: