Provider Demographics
NPI:1679759237
Name:TANAKA AND ASSOCIATES CHIROPRACTIC & MASSAGE, LLC
Entity Type:Organization
Organization Name:TANAKA AND ASSOCIATES CHIROPRACTIC & MASSAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:TANAKA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-487-2273
Mailing Address - Street 1:98-027 HEKAHA ST STE 17
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4919
Mailing Address - Country:US
Mailing Address - Phone:808-487-2273
Mailing Address - Fax:808-356-0337
Practice Address - Street 1:98-027 HEKAHA ST STE 17
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4919
Practice Address - Country:US
Practice Address - Phone:808-487-2273
Practice Address - Fax:808-356-0337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC751111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI55630Medicare PIN