Provider Demographics
NPI:1245253665
Name:YAMANOHA, DORIS (RD)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:YAMANOHA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:DORIS
Other - Middle Name:
Other - Last Name:GOYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:71 ALOHALANI DR
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-5550
Mailing Address - Country:US
Mailing Address - Phone:808-959-9948
Mailing Address - Fax:
Practice Address - Street 1:868 ULULANI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3913
Practice Address - Country:US
Practice Address - Phone:808-934-9400
Practice Address - Fax:808-934-0232
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL473767133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic