Provider Demographics
NPI:1619268968
Name:PAU HANA MASSAGE LLC
Entity Type:Organization
Organization Name:PAU HANA MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PUALILIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAIKULI
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:808-327-5664
Mailing Address - Street 1:75-5741 KUAKINI HWY
Mailing Address - Street 2:#A
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-3724
Mailing Address - Country:US
Mailing Address - Phone:808-327-5664
Mailing Address - Fax:
Practice Address - Street 1:75-5741 KUAKINI HWY
Practice Address - Street 2:#A
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-3724
Practice Address - Country:US
Practice Address - Phone:808-327-5664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2596225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty