Provider Demographics
NPI:1447361282
Name:TAMASHIRO, DONNA (OTR)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:
Last Name:TAMASHIRO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HANA HWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2300
Mailing Address - Country:US
Mailing Address - Phone:808-877-8717
Mailing Address - Fax:808-877-8718
Practice Address - Street 1:111 HANA HWY
Practice Address - Street 2:SUITE 107
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2300
Practice Address - Country:US
Practice Address - Phone:808-877-8717
Practice Address - Fax:808-877-8718
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT122225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07328102Medicaid
HI07328102Medicaid