Provider Demographics
NPI:1568616795
Name:YANAGI, OLIVIA C (PT)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:C
Last Name:YANAGI
Suffix:
Gender:F
Credentials:PT
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 300
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5845
Mailing Address - Country:US
Mailing Address - Phone:808-737-4244
Mailing Address - Fax:808-737-2220
Practice Address - Street 1:3221 WAIALAE AVE STE 300
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5845
Practice Address - Country:US
Practice Address - Phone:808-737-4244
Practice Address - Fax:808-737-2220
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-1067225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIPT-1067OtherPT LICENSE