Provider Demographics
NPI:1568600880
Name:MEDEARIS, ERIN CHIEKO HAUNANI (OT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:CHIEKO HAUNANI
Last Name:MEDEARIS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:CHIEKO HAUNANI
Other - Last Name:ARAKAWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:575 FARRINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2001
Mailing Address - Country:US
Mailing Address - Phone:808-674-9262
Mailing Address - Fax:808-674-8481
Practice Address - Street 1:575 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2001
Practice Address - Country:US
Practice Address - Phone:808-674-9262
Practice Address - Fax:808-674-8481
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI906225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist