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General NPI Number Information
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NPI Number | 1164134722
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Entity Type | Organization
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Legal Business Name | AVENTURINE MASSAGE LLC
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Dates
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Enumeration Date | 12/15/2022
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Last Update Date | 09/01/2025
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Provider Practice Location Address
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Address Line | 803 KAMEHAMEHA HWY STE 312
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City | PEARL CITY
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State | HI
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Zip | 96782-2638
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Country | US
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Telephone | 808-232-5215
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Fax |
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Provider Business Mailing Address
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Address Line | 94-780 HOOMELE PL
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City | WAIPAHU
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State | HI
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Zip | 96797-4232
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Country | US
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Telephone | 808-232-5215
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Fax |
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Authorized Official
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Title or Position | OWNER/MASSAGE THERAPIST
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Name | GLORIA LYNN SUNIGA
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Credential |
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Telephone | 808-232-5215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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