Provider Demographics
NPI:1841567179
Name:HARAGUCHI, EMELIA LOREN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:EMELIA
Middle Name:LOREN
Last Name:HARAGUCHI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:EMELIA
Other - Middle Name:LOREN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 83
Mailing Address - Street 2:
Mailing Address - City:HANALEI
Mailing Address - State:HI
Mailing Address - Zip Code:96714-0083
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2-2488 KAUMUALII HWY
Practice Address - Street 2:
Practice Address - City:KALAHEO
Practice Address - State:HI
Practice Address - Zip Code:96741-8311
Practice Address - Country:US
Practice Address - Phone:808-335-5657
Practice Address - Fax:808-335-5657
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38459225100000X
HI35262251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIGN899ZMedicare PIN