=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609059559
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANEL KAI L.M.T.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/14/2007
-----------------------------------------------------
Last Update Date | 12/14/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | HC 1 BOX 4186
-----------------------------------------------------
City | KEAAU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96749-8701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-982-8237
-----------------------------------------------------
Fax | 808-969-7922
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 420 AINAOLA DR
-----------------------------------------------------
City | HILO
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96720-3305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-640-0668
-----------------------------------------------------
Fax | 808-969-7922
-----------------------------------------------------
=====================================================
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 | 10411
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------