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General NPI Number Information
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NPI Number | 1629590815
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Entity Type | Organization
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Legal Business Name | HALE LAPAAU SKIN AND BODY LLC
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 07/10/2017
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Provider Practice Location Address
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Address Line | 1051 KEOLU DR STE 104
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City | KAILUA
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State | HI
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Zip | 96734-3800
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Country | US
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Telephone | 808-367-3397
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6246
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City | KANEOHE
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State | HI
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Zip | 96744-9171
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ LICENSED MASSAGE THERAPIST
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Name | MS. TIARE N T YANAGI
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Credential |
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Telephone | 808-367-3397
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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 | MAT-10756
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License Number State | HI
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