Provider Demographics
NPI:1467787887
Name:TUPASI, LAURIE (LMT)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:
Last Name:TUPASI
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 2872
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-2872
Mailing Address - Country:US
Mailing Address - Phone:808-327-1888
Mailing Address - Fax:
Practice Address - Street 1:75-5995 KUAKINI HWY
Practice Address - Street 2:#801B
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2144
Practice Address - Country:US
Practice Address - Phone:808-327-1888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-03
Last Update Date:2009-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4514225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist