Provider Demographics
NPI:1265944417
Name:PABLO, NORIKO
Entity type:Individual
Prefix:
First Name:NORIKO
Middle Name:
Last Name:PABLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 CITRON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-4791
Mailing Address - Country:US
Mailing Address - Phone:808-772-8533
Mailing Address - Fax:
Practice Address - Street 1:1580 MAKALOA ST STE 880
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3258
Practice Address - Country:US
Practice Address - Phone:808-772-8533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-14153225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist