Provider Demographics
NPI:1093054066
Name:CHINEN, JAMIE LEIALOHA VARES (MAT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEIALOHA VARES
Last Name:CHINEN
Suffix:
Gender:F
Credentials:MAT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LEIALOHA
Other - Last Name:VARES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAT
Mailing Address - Street 1:99-128 AIEA HEIGHTS DR
Mailing Address - Street 2:STE 505
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3925
Mailing Address - Country:US
Mailing Address - Phone:808-382-1892
Mailing Address - Fax:
Practice Address - Street 1:99-128 AIEA HEIGHTS DR
Practice Address - Street 2:STE 505
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3925
Practice Address - Country:US
Practice Address - Phone:808-382-1892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI12218225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist