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General NPI Number Information
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NPI Number | 1689393951
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Entity Type | Individual
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Provider Name | DAMIEN STEVENS LMT
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Gender | Male
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 94-810 MOLOALO ST STE 220
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City | WAIPAHU
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State | HI
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Zip | 96797-3355
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Country | US
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Telephone | 808-671-1711
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Fax | 808-671-1705
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Provider Business Mailing Address
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Address Line | 283 AIKAHI PL
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City | KAILUA
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State | HI
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Zip | 96734-1648
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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 |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MAT-13200
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License Number State | HI
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