Provider Demographics
NPI:1518238963
Name:MIYASHIRO, THOMAS H (MSCP)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:H
Last Name:MIYASHIRO
Suffix:
Gender:M
Credentials:MSCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2054 HOOHAI ST
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-1423
Mailing Address - Country:US
Mailing Address - Phone:808-383-7494
Mailing Address - Fax:808-545-2852
Practice Address - Street 1:1020 S BERETANIA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1428
Practice Address - Country:US
Practice Address - Phone:808-545-2740
Practice Address - Fax:808-545-2852
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI421106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist