Healthcare Provider Details

I. General information

NPI: 1427969450
Provider Name (Legal Business Name): SASANN KAAWA LMT
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12-7004 HOKUAO ST # 50
PAHOA HI
96778-7892
US

IV. Provider business mailing address

12-7004 HOKUAO ST # 50
PAHOA HI
96778-7892
US

V. Phone/Fax

Practice location:
  • Phone: 808-557-8807
  • Fax: 844-781-8303
Mailing address:
  • Phone: 808-557-8807
  • Fax: 844-781-8303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT-16999
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: