Provider Demographics
NPI:1003678616
Name:NORDEN, DEBORAH S
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:NORDEN
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 1:623 WANAAO RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3556
Mailing Address - Country:US
Mailing Address - Phone:808-909-1547
Mailing Address - Fax:
Practice Address - Street 1:500 ALA MOANA BLVD STE 6D
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4984
Practice Address - Country:US
Practice Address - Phone:808-680-9123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-17399225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist