Healthcare Provider Details

I. General information

NPI: 1144143645
Provider Name (Legal Business Name): ALAHNA BALLESTEROS-MAKUA MAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2176 LAUWILIWILI ST STE 1
KAPOLEI HI
96707-1882
US

IV. Provider business mailing address

91-543 PAPIPI RD
EWA BEACH HI
96706-2336
US

V. Phone/Fax

Practice location:
  • Phone: 808-745-8651
  • Fax:
Mailing address:
  • Phone: 808-419-1936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT-18506
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: