MEDICARE: MARINA IGNACIO

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	MAT-13917	HI
2	101YM0800X	Mental Health Counselor	MHC-1023	HI

General Provider Information

NPI Number	:	1245723949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARINA IGNACIO

Provider Business Mailing Address
First Line	:	PO BOX 10969
Second Line	:
City	:	HILO
State	:	HI
Zip	:	96721-5969
Country	:	US
Telephone Number	:	808-936-3329
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 10969
Second Line	:
City	:	HILO
State	:	HI
Zip	:	96721-5969
Country	:	US
Telephone Number	:	808-936-3329
Fax Number	:

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

Provider Enumeration Date	:	06/07/2018
Last Update Date	:	07/18/2025

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Directions to “ MARINA IGNACIO ” Practice Location

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