Provider Demographics
NPI:1558728618
Name:NEWMAN, WENDY (MT)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 WAIALAE AVE STE 360
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5849
Mailing Address - Country:US
Mailing Address - Phone:808-734-0020
Mailing Address - Fax:808-732-0010
Practice Address - Street 1:3221 WAIALAE AVE STE 360
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5849
Practice Address - Country:US
Practice Address - Phone:808-734-0020
Practice Address - Fax:808-732-0010
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMT-7109225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist