Provider Demographics
NPI:1366487837
Name:DACUMOS, JASON A (PT, MPT, OCS)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:A
Last Name:DACUMOS
Suffix:
Gender:M
Credentials:PT, MPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7114 NIUMALU LOOP
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-1635
Mailing Address - Country:US
Mailing Address - Phone:808-783-9320
Mailing Address - Fax:808-396-5581
Practice Address - Street 1:7114 NIUMALU LOOP
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1635
Practice Address - Country:US
Practice Address - Phone:808-783-9320
Practice Address - Fax:808-396-5581
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-2561174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist