Provider Demographics
NPI:1043098791
Name:SASAKI, KAHIWALANI MARANATA MALO
Entity type:Individual
Prefix:
First Name:KAHIWALANI
Middle Name:MARANATA MALO
Last Name:SASAKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2423 AUHUHU ST
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-1041
Mailing Address - Country:US
Mailing Address - Phone:808-721-4147
Mailing Address - Fax:
Practice Address - Street 1:2423 AUHUHU ST
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-1041
Practice Address - Country:US
Practice Address - Phone:808-721-4147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist