Provider Demographics
NPI:1063025757
Name:UWAINE, ALYSSA ANN CAITLYN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALYSSA ANN
Middle Name:CAITLYN
Last Name:UWAINE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2354 SAINT LOUIS DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-2029
Mailing Address - Country:US
Mailing Address - Phone:808-753-0230
Mailing Address - Fax:
Practice Address - Street 1:2354 SAINT LOUIS DR
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2029
Practice Address - Country:US
Practice Address - Phone:808-753-0230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5053225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist