Healthcare Provider Details

I. General information

NPI: 1811627284
Provider Name (Legal Business Name): KRISTIN D. BAYUDAN DPT,LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95-720 LANIKUHANA AVE STE 140
MILILANI HI
96789-2986
US

IV. Provider business mailing address

98-1375 KOAHEAHE PL APT 99
PEARL CITY HI
96782-3510
US

V. Phone/Fax

Practice location:
  • Phone: 808-623-6244
  • Fax: 808-623-6414
Mailing address:
  • Phone: 808-284-9435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT-15713
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-6324
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: