Provider Demographics
NPI:1548588213
Name:DEAL, JANET LYNN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LYNN
Last Name:DEAL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:JANET
Other - Middle Name:LYNN
Other - Last Name:SLATTERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 E PUAINAKO ST
Mailing Address - Street 2:585-211
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-5288
Mailing Address - Country:US
Mailing Address - Phone:808-430-5509
Mailing Address - Fax:
Practice Address - Street 1:74 KAPIOLANI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2943
Practice Address - Country:US
Practice Address - Phone:808-935-8191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10691225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist