Provider Demographics
NPI:1467632000
Name:ISHIKAWA, IRENE MEI OI KAWAMOTO (DPT)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:MEI OI KAWAMOTO
Last Name:ISHIKAWA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 FARRINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:575 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2001
Practice Address - Country:US
Practice Address - Phone:808-674-9262
Practice Address - Fax:808-674-8481
Is Sole Proprietor?:No
Enumeration Date:2007-11-12
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-2762225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist