Provider Demographics
NPI:1558880856
Name:YAMAMOTO, ADRIENNE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:
Last Name:YAMAMOTO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 PIIKOI ST APT 503
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-4026
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:94-1388 MOANIANI ST STE 243
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-6606
Practice Address - Country:US
Practice Address - Phone:808-744-5161
Practice Address - Fax:808-744-6639
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH117869Medicaid