Provider Demographics
NPI:1437425014
Name:KA PUNAWAI OLA
Entity Type:Organization
Organization Name:KA PUNAWAI OLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RSM/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-674-4006
Mailing Address - Street 1:575 FARRINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707
Mailing Address - Country:US
Mailing Address - Phone:808-674-4006
Mailing Address - Fax:808-674-4007
Practice Address - Street 1:575 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707
Practice Address - Country:US
Practice Address - Phone:808-674-4006
Practice Address - Fax:808-674-4007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI12-5051Medicare PIN