Provider Demographics
NPI:1902194145
Name:TATSUNO, KATHERINE M (PT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:TATSUNO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 12TH AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-3790
Mailing Address - Country:US
Mailing Address - Phone:808-734-4043
Mailing Address - Fax:808-737-7247
Practice Address - Street 1:1120 12TH AVE STE 302
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-3790
Practice Address - Country:US
Practice Address - Phone:808-734-4043
Practice Address - Fax:808-737-7247
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT 3389225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist