Provider Demographics
NPI:1225462609
Name:DURKAN, CHRISTIAN SWENSON (LMT LISCENSE MASSAGE)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:SWENSON
Last Name:DURKAN
Suffix:
Gender:M
Credentials:LMT LISCENSE MASSAGE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 KAUHIKOA RD
Mailing Address - Street 2:
Mailing Address - City:HAIKU
Mailing Address - State:HI
Mailing Address - Zip Code:96708-5830
Mailing Address - Country:US
Mailing Address - Phone:808-280-1351
Mailing Address - Fax:
Practice Address - Street 1:1280 KAUHIKOA RD
Practice Address - Street 2:
Practice Address - City:HAIKU
Practice Address - State:HI
Practice Address - Zip Code:96708-5830
Practice Address - Country:US
Practice Address - Phone:808-280-1351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8704225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist