MEDICARE: LIANE YURI NAKAMICHI

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1205472982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIANE YURI NAKAMICHI

Provider Business Mailing Address
First Line	:	860 4TH ST
Second Line	:
City	:	PEARL CITY
State	:	HI
Zip	:	96782-3690
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	860 4TH ST
Second Line	:
City	:	PEARL CITY
State	:	HI
Zip	:	96782-3690
Country	:	US
Telephone Number	:	808-453-6596
Fax Number	:

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

Provider Enumeration Date	:	11/18/2019
Last Update Date	:	11/18/2019

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Directions to “ LIANE YURI NAKAMICHI ” Practice Location

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