Provider Demographics
NPI:1417362922
Name:AIPA, TASHA (LMT, MBA)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:
Last Name:AIPA
Suffix:
Gender:F
Credentials:LMT, MBA
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 384718
Mailing Address - Street 2:
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738-4718
Mailing Address - Country:US
Mailing Address - Phone:808-688-8178
Mailing Address - Fax:
Practice Address - Street 1:68-1845 WAIKOLOA RD
Practice Address - Street 2:STE 201
Practice Address - City:WAIKOLOA
Practice Address - State:HI
Practice Address - Zip Code:96738-5584
Practice Address - Country:US
Practice Address - Phone:808-960-8333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT12328171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI12328OtherMASSAGE THERAPY