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General NPI Number Information
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NPI Number | 1881147957
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Entity Type | Individual
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Provider Name | MINAKO TSUKAHARA ATC
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Gender | Female
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Dates
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Enumeration Date | 07/25/2016
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 2526 10TH AVE
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City | HONOLULU
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State | HI
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Zip | 96816-3031
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Country | US
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Telephone | 808-733-8465
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Fax | 808-733-8467
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Provider Business Mailing Address
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Address Line | 2526 10TH AVE
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City | HONOLULU
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State | HI
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Zip | 96816-3031
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Country | US
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Telephone | 808-733-8465
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Fax | 808-733-8467
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT - 36
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License Number State | HI
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