Provider Demographics
NPI:1891896155
Name:KATAYAMA, JASON KEN (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:KEN
Last Name:KATAYAMA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 WAIALAE AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5831
Mailing Address - Country:US
Mailing Address - Phone:808-734-5059
Mailing Address - Fax:808-734-2766
Practice Address - Street 1:3221 WAIALAE AVE STE 330
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-5831
Practice Address - Country:US
Practice Address - Phone:808-734-5059
Practice Address - Fax:808-734-2766
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC-896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI24016-8OtherHMSA
HI24016-8OtherHMSA
HIU95187Medicare UPIN