=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124897954
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHAYLA K PANG KEE LMT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2023
-----------------------------------------------------
Last Update Date | 03/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1090 KEOLU DRIVE STE 104
-----------------------------------------------------
City | KAILUA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96734-3871
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-262-2292
-----------------------------------------------------
Fax | 808-262-2293
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 45-450A HOENE PL
-----------------------------------------------------
City | KANEOHE
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96744-2950
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-284-7905
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MAT-17463
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------