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General NPI Number Information
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NPI Number | 1487371167
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Entity Type | Individual
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Provider Name | SHELLEE N TAKARA DPT
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Gender | Female
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Dates
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Enumeration Date | 10/24/2022
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 99-115 AIEA HEIGHTS DR STE 253
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City | AIEA
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State | HI
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Zip | 96701-3975
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Country | US
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Telephone | 808-773-8811
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Fax | 808-495-4418
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Provider Business Mailing Address
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Address Line | 98-657 PAPALEALII ST
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City | AIEA
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State | HI
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Zip | 96701-2755
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Country | US
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Telephone | 808-773-8811
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Fax | 808-495-4418
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-5526
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License Number State | HI
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