Provider Demographics
NPI:1043264237
Name:YANAGI, GRIFFITH T (PT)
Entity Type:Individual
Prefix:
First Name:GRIFFITH
Middle Name:T
Last Name:YANAGI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-1247 KAAHUMANU ST
Mailing Address - Street 2:118B
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5311
Mailing Address - Country:US
Mailing Address - Phone:808-488-4243
Mailing Address - Fax:808-484-2229
Practice Address - Street 1:98-1247 KAAHUMANU ST
Practice Address - Street 2:118B
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5311
Practice Address - Country:US
Practice Address - Phone:808-488-4243
Practice Address - Fax:808-484-2229
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-1053225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI24491402Medicaid
HIH53172Medicare PIN