Provider Demographics
NPI:1164548111
Name:LEE, LIN FAR (PT)
Entity Type:Individual
Prefix:
First Name:LIN FAR
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 N KING ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4226
Mailing Address - Country:US
Mailing Address - Phone:808-847-7440
Mailing Address - Fax:
Practice Address - Street 1:1427 N KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4226
Practice Address - Country:US
Practice Address - Phone:808-847-7440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000259564OtherHMSA
HI4933610OtherUHA PROVIDER #
HI543192OtherHMA
HI583709Medicaid
HI0000259564OtherHMSA