Provider Demographics
NPI:1750456174
Name:PREIS, SAMANTHA GRAYCE (LAC, DIPL OM)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:GRAYCE
Last Name:PREIS
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Gender:F
Credentials:LAC, DIPL OM
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Mailing Address - Street 1:46-001 KAMEHAMEHA HWY
Mailing Address - Street 2:SUITE 317C
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3711
Mailing Address - Country:US
Mailing Address - Phone:808-247-9800
Mailing Address - Fax:888-291-1653
Practice Address - Street 1:46-001 KAMEHAMEHA HWY
Practice Address - Street 2:SUITE 317C
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3711
Practice Address - Country:US
Practice Address - Phone:808-247-9800
Practice Address - Fax:888-291-1653
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2010-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIACU-601171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HISS1038463OtherASHN ID NUMBER