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General NPI Number Information
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NPI Number | 1629309331
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Entity Type | Organization
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Legal Business Name | PAKOLEA
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Dates
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Enumeration Date | 01/20/2010
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 215-C RAILROAD AVE BAYS 11-14
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City | HILO
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State | HI
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Zip | 96720-2990
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Country | US
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Telephone | 808-935-5255
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Fax | 808-961-9044
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Provider Business Mailing Address
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Address Line | PO BOX 6783
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City | HILO
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State | HI
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Zip | 96720
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Country | US
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Telephone | 808-935-5255
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Fax | 808-961-9044
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAUNA KA'IULANI RUSSELL
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Credential | DPT
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Telephone | 808-935-5255
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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-3052
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | PT-3052
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License Number State | HI
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