Provider Demographics
NPI:1073056180
Name:ITO, RYOKO (LAC, LMT)
Entity Type:Individual
Prefix:
First Name:RYOKO
Middle Name:
Last Name:ITO
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 AUWINA ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3430
Mailing Address - Country:US
Mailing Address - Phone:808-345-1380
Mailing Address - Fax:
Practice Address - Street 1:667 AUWINA ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-3430
Practice Address - Country:US
Practice Address - Phone:808-345-1380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-1175171100000X
HIMAT-14231225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist