Provider Demographics
NPI:1710251525
Name:FREI, AKIKO ISHIZUKA (LMT)
Entity Type:Individual
Prefix:MS
First Name:AKIKO
Middle Name:ISHIZUKA
Last Name:FREI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4348 WAIALAE AVE # 128
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5767
Mailing Address - Country:US
Mailing Address - Phone:808-688-3861
Mailing Address - Fax:808-200-7933
Practice Address - Street 1:4747 KILAUEA AVE STE 205
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5308
Practice Address - Country:US
Practice Address - Phone:808-688-3861
Practice Address - Fax:808-200-7933
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI9511225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist