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NPI 1801323761

NPI 1801323761 : DERWIN H DOI LICENSED MASSAGE THE : HONOLULU, HI

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General NPI Number Information
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    NPI Number           |    1801323761
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    Entity Type          |    Individual 
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    Provider Name        |    DERWIN H DOI LICENSED MASSAGE THE
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/22/2017
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    Last Update Date     |    06/20/2018
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Provider Practice Location Address
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    Address Line         |    2875 S KING ST STE 205 
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96826-3564
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    Country              |    US
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    Telephone            |    808-256-1358
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    965 HONOKAHUA PL 
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96825-3032
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    Country              |    US
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    Telephone            |    808-256-1358
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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       |    4524
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    License Number State |    HI
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