Provider Demographics
NPI:1376945865
Name:JENKINS, RAGNHILD AASEN (PT)
Entity Type:Individual
Prefix:
First Name:RAGNHILD
Middle Name:AASEN
Last Name:JENKINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 901559
Mailing Address - Street 2:
Mailing Address - City:KULA
Mailing Address - State:HI
Mailing Address - Zip Code:96790-1559
Mailing Address - Country:US
Mailing Address - Phone:808-269-2972
Mailing Address - Fax:
Practice Address - Street 1:1106 PUANA ST
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-9436
Practice Address - Country:US
Practice Address - Phone:808-269-2972
Practice Address - Fax:808-878-1879
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3855225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist