=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346758190
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MA JANNETTE RELAMPAGOS LAMBERT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/15/2018
-----------------------------------------------------
Last Update Date | 12/11/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1790B MAKALEHA PL
-----------------------------------------------------
City | KAPAA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96746-8013
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-652-1041
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1790B MAKALEHA PL
-----------------------------------------------------
City | KAPAA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96746-8013
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-652-1041
-----------------------------------------------------
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 | MAE-3383
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MAT-14946
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------