Provider Demographics
NPI:1346758190
Name:LAMBERT, MA JANNETTE RELAMPAGOS
Entity Type:Individual
Prefix:
First Name:MA JANNETTE
Middle Name:RELAMPAGOS
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MA JANNETTE
Other - Middle Name:RELAMPAGOS
Other - Last Name:LAMBERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1790B MAKALEHA PL
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-8013
Mailing Address - Country:US
Mailing Address - Phone:808-652-1041
Mailing Address - Fax:
Practice Address - Street 1:1790B MAKALEHA PL
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-8013
Practice Address - Country:US
Practice Address - Phone:808-652-1041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-15
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAE-3383225700000X
HIMAT-14946225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist