1225790140 NPI number — ELIZABETH R STRAIN DPT

Table of content: ELIZABETH R STRAIN DPT (NPI 1225790140)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225790140 NPI number — ELIZABETH R STRAIN DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRAIN
Provider First Name:
ELIZABETH
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225790140
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/31/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
37 KUAIWA WAY
Provider Second Line Business Mailing Address:
UNIT 20D
Provider Business Mailing Address City Name:
WAILUKU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96793-3115
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-260-9186
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
135 WAKEA AVE
Provider Second Line Business Practice Location Address:
#112
Provider Business Practice Location Address City Name:
KAHULI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96732-1385
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-280-7711
Provider Business Practice Location Address Fax Number:
808-442-0690
Provider Enumeration Date:
10/07/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT5371 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: 296317 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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