MEDICARE: KELLEN TASAKA DPT

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1518817766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLEN TASAKA DPT

Provider Business Mailing Address
First Line	:	739 HAUSTEN ST
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96826-3020
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	745 FORT ST STE 116
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96813-3823
Country	:	US
Telephone Number	:	808-599-5500
Fax Number	:

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

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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Directions to “ KELLEN TASAKA DPT” Practice Location

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