Provider Demographics
NPI:1205013489
Name:MORRISON, ELAINE S (LMT)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:S
Last Name:MORRISON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78-7070 ALII DR
Mailing Address - Street 2:A103
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2562
Mailing Address - Country:US
Mailing Address - Phone:808-324-6160
Mailing Address - Fax:
Practice Address - Street 1:75-166 KALANI ST
Practice Address - Street 2:SUITE 203
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1857
Practice Address - Country:US
Practice Address - Phone:808-329-5155
Practice Address - Fax:808-329-2726
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT10035225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist