Provider Demographics
NPI:1033551478
Name:COLLADO, MAILE M K (MPT)
Entity Type:Individual
Prefix:MRS
First Name:MAILE
Middle Name:M K
Last Name:COLLADO
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:MAILE
Other - Middle Name:MAE
Other - Last Name:KAWANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 970068
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-0068
Mailing Address - Country:US
Mailing Address - Phone:808-600-9148
Mailing Address - Fax:800-942-7053
Practice Address - Street 1:94-216 FARRINGTON HWY # A102
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1922
Practice Address - Country:US
Practice Address - Phone:808-600-9148
Practice Address - Fax:800-942-7053
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-26
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1484225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist