Provider Demographics
NPI:1164032876
Name:MANAYAO, DYMPHNA R
Entity Type:Individual
Prefix:
First Name:DYMPHNA
Middle Name:R
Last Name:MANAYAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1542 IAO LN
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2930
Mailing Address - Country:US
Mailing Address - Phone:808-397-4366
Mailing Address - Fax:808-847-0730
Practice Address - Street 1:1542 IAO LN
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2930
Practice Address - Country:US
Practice Address - Phone:808-397-4366
Practice Address - Fax:808-847-0730
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHI000010005E376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide