Provider Demographics
NPI:1821366139
Name:HANZAWA, TARYN (DPT)
Entity Type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:HANZAWA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:TARYN
Other - Middle Name:
Other - Last Name:KITAMURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44-132 NANAMOANA ST
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2557
Mailing Address - Country:US
Mailing Address - Phone:808-728-8779
Mailing Address - Fax:
Practice Address - Street 1:3288 MOANALUA RD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1469
Practice Address - Country:US
Practice Address - Phone:808-432-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3443225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist