Provider Demographics
NPI:1922131416
Name:THOMAS, DONNA J (LMT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6126
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-6126
Mailing Address - Country:US
Mailing Address - Phone:808-885-4459
Mailing Address - Fax:808-885-4459
Practice Address - Street 1:64-1061 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8482
Practice Address - Country:US
Practice Address - Phone:808-885-4459
Practice Address - Fax:808-885-4459
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT0894225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist