Provider Demographics
NPI:1760697841
Name:SAKAGAWA, GINN C (MPT)
Entity Type:Individual
Prefix:MRS
First Name:GINN
Middle Name:C
Last Name:SAKAGAWA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10327
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-0327
Mailing Address - Country:US
Mailing Address - Phone:808-739-1977
Mailing Address - Fax:808-739-1979
Practice Address - Street 1:1029 KAPAHULU AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1332
Practice Address - Country:US
Practice Address - Phone:808-739-1977
Practice Address - Fax:808-739-1979
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2300225100000X
HI225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIPT2300OtherLICENSE