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General NPI Number Information
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NPI Number | 1861854531
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Entity Type | Individual
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Provider Name | SORAYA FARIS APPLEGATE L.AC
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Gender | Female
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 45-696 KAMEHAMEHA HWY
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City | KANEOHE
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State | HI
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Zip | 96744-2034
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Country | US
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Telephone | 808-721-3083
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Fax |
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Provider Business Mailing Address
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Address Line | 46-063 EMEPELA PL V/100
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City | KANEOHE
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State | HI
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Zip | 96744-3947
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Country | US
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Telephone | 808-721-3083
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 1133
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License Number State | HI
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