Provider Demographics
NPI:1073046678
Name:OKADA, CHELSEA (MS, ATC)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:OKADA
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-1035 KOOLANI DR
Mailing Address - Street 2:APT 71
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-4970
Mailing Address - Country:US
Mailing Address - Phone:808-554-0797
Mailing Address - Fax:
Practice Address - Street 1:91-980 NORTH RD
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-2746
Practice Address - Country:US
Practice Address - Phone:808-305-3676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAT-2702255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer