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General NPI Number Information
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NPI Number | 1871147413
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Entity Type | Individual
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Provider Name | KESA TONG-ISHIKAWA
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Gender | Female
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Dates
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Enumeration Date | 08/01/2019
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Last Update Date | 08/14/2019
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Provider Practice Location Address
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Address Line | 407 ULUNIU ST STE 204
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City | KAILUA
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State | HI
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Zip | 96734-2536
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Country | US
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Telephone | 808-266-2468
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Fax |
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Provider Business Mailing Address
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Address Line | 47-714 HUI KELU ST APT 4
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City | KANEOHE
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State | HI
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Zip | 96744-4555
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Country | US
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Telephone | 808-266-2468
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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-9419
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License Number State | HI
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