Provider Demographics
NPI:1376789297
Name:NAKAMOTO, JULEEN A
Entity Type:Individual
Prefix:
First Name:JULEEN
Middle Name:A
Last Name:NAKAMOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45-1144 KAMEHAMEHA HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3244
Mailing Address - Country:US
Mailing Address - Phone:808-236-1529
Mailing Address - Fax:808-236-0844
Practice Address - Street 1:45-1144 KAMEHAMEHA HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3244
Practice Address - Country:US
Practice Address - Phone:808-236-1529
Practice Address - Fax:808-236-0844
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2075174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist