Healthcare Provider Details

I. General information

NPI: 1144144676
Provider Name (Legal Business Name): OHANA CHIROPRACTIC CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1638 MAIN ST STE 102
FREELAND WA
98249-9677
US

IV. Provider business mailing address

4617 PINTAIL RD
LANGLEY WA
98260-9632
US

V. Phone/Fax

Practice location:
  • Phone: 808-450-0995
  • Fax: 808-450-0995
Mailing address:
  • Phone: 808-450-0995
  • Fax: 808-450-0995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MR. RANDY KIWINI BALDOMERO
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: BALDOMERO
Phone: 808-450-0995