MEDICARE: REBECCA LEILANI DOESCHER LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	7145	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1052259	OTHER	HI	AMERICAN SPECIALTY HEALTH

General Provider Information

NPI Number	:	1093889834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA LEILANI DOESCHER LMT

Provider Business Mailing Address
First Line	:	1471 PUEO ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-5301
Country	:	US
Telephone Number	:	808-282-6981
Fax Number	:	808-732-4244

Provider Business Practice Location Address
First Line	:	4747 KILAUEA AVE
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-5308
Country	:	US
Telephone Number	:	808-732-2244
Fax Number	:	808-732-4244

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	07/08/2007

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