Provider Demographics
NPI:1659707297
Name:MONTOYA, VALERIE L (LAC)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:L
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-1038 MOANALUA RD
Mailing Address - Street 2:APT 7-603
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4620
Mailing Address - Country:US
Mailing Address - Phone:808-499-4484
Mailing Address - Fax:
Practice Address - Street 1:407 ULUNIU ST
Practice Address - Street 2:STE. 412
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2519
Practice Address - Country:US
Practice Address - Phone:808-230-2476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-14
Last Update Date:2013-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-977171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist