Provider Demographics
NPI:1982009502
Name:NORTH, CHELSEA J (LMT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:J
Last Name:NORTH
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 1:25 WAIPAA LN
Mailing Address - Street 2:44-101
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-6003
Mailing Address - Country:US
Mailing Address - Phone:808-492-8547
Mailing Address - Fax:
Practice Address - Street 1:181 LAHAINALUNA ROAD
Practice Address - Street 2:SUITE D
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761
Practice Address - Country:US
Practice Address - Phone:808-661-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-13101225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist