Provider Demographics
NPI:1235667221
Name:HEALING SEAS ACUPUNCTURE KAUAI LLC
Entity Type:Organization
Organization Name:HEALING SEAS ACUPUNCTURE KAUAI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DIPLAC
Authorized Official - Phone:808-278-3785
Mailing Address - Street 1:5116 KAHANA ST
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-2152
Mailing Address - Country:US
Mailing Address - Phone:808-278-3785
Mailing Address - Fax:
Practice Address - Street 1:5116 KAHANA ST
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-2152
Practice Address - Country:US
Practice Address - Phone:808-278-3785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-02
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1179171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty