Provider Demographics
NPI:1932643541
Name:SCHOONMAKER, KEVIN M (LMT)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:M
Last Name:SCHOONMAKER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 KAPAHULU AVE STE E
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-6020
Mailing Address - Country:US
Mailing Address - Phone:336-392-3289
Mailing Address - Fax:
Practice Address - Street 1:750 KAPAHULU AVE STE D
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-6020
Practice Address - Country:US
Practice Address - Phone:336-392-3289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-14341225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty