Provider Demographics
NPI:1043420482
Name:WATTS, PATRICIA E (LMT)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:E
Last Name:WATTS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2013 MAKANANI DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2033
Mailing Address - Country:US
Mailing Address - Phone:808-722-5182
Mailing Address - Fax:808-595-0509
Practice Address - Street 1:98-027 HEKAHA ST
Practice Address - Street 2:BLDG 3 SUITE 21
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4910
Practice Address - Country:US
Practice Address - Phone:808-722-5182
Practice Address - Fax:808-595-0509
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5645225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist