Provider Demographics
NPI:1508274309
Name:TAKABUKI, JAYMEE M (RD)
Entity Type:Individual
Prefix:
First Name:JAYMEE
Middle Name:M
Last Name:TAKABUKI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:JAYMEE
Other - Middle Name:M
Other - Last Name:WAKUMOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1025 KALO PL APT 608
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1614
Mailing Address - Country:US
Mailing Address - Phone:808-691-7546
Mailing Address - Fax:
Practice Address - Street 1:1025 KALO PL APT 608
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1614
Practice Address - Country:US
Practice Address - Phone:808-691-7546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2020-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered