Provider Demographics
NPI:1902207814
Name:EBESU, DAWN TSUKI (OTR)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:TSUKI
Last Name:EBESU
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:DAWN
Other - Middle Name:TSUKI
Other - Last Name:GUSHIKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:826 S KING ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:826 S KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3009
Practice Address - Country:US
Practice Address - Phone:808-523-9043
Practice Address - Fax:808-526-0673
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT-2225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist