Provider Demographics
NPI:1407990559
Name:YAMAMOTO, KERI MICHIE (OTR, LMT)
Entity Type:Individual
Prefix:MS
First Name:KERI
Middle Name:MICHIE
Last Name:YAMAMOTO
Suffix:
Gender:F
Credentials:OTR, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 HOOLI CIR
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-1910
Mailing Address - Country:US
Mailing Address - Phone:808-455-7325
Mailing Address - Fax:
Practice Address - Street 1:432 KEAWE ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5125
Practice Address - Country:US
Practice Address - Phone:808-389-9638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-6310225700000X
WAMA00012228225700000X
HIOT-278225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist