Provider Demographics
NPI:1417296906
Name:OKAZAKI, ELLEN CHITOSE (LMT)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:CHITOSE
Last Name:OKAZAKI
Suffix:
Gender:F
Credentials:LMT
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 6318
Mailing Address - Street 2:KANEOHE
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-9172
Mailing Address - Country:US
Mailing Address - Phone:808-389-0532
Mailing Address - Fax:
Practice Address - Street 1:32 KAINEHE ST
Practice Address - Street 2:SUITE 207
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2670
Practice Address - Country:US
Practice Address - Phone:808-389-0532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI12624225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist