Provider Demographics
NPI:1851690689
Name:KAMIGAKI, KELLIE (DPT)
Entity Type:Individual
Prefix:MS
First Name:KELLIE
Middle Name:
Last Name:KAMIGAKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 KAMOKILA BLVD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2014
Mailing Address - Country:US
Mailing Address - Phone:808-674-9595
Mailing Address - Fax:808-674-9696
Practice Address - Street 1:1001 KAMOKILA BLVD
Practice Address - Street 2:SUITE 114
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2014
Practice Address - Country:US
Practice Address - Phone:808-674-9595
Practice Address - Fax:808-674-9696
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3306225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist