Provider Demographics
NPI:1457404022
Name:YAFUSO, KAREN L (RD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:YAFUSO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 FARRINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2001
Mailing Address - Country:US
Mailing Address - Phone:808-432-3600
Mailing Address - Fax:
Practice Address - Street 1:599 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2001
Practice Address - Country:US
Practice Address - Phone:808-432-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH54633Medicare PIN
HIP61507Medicare UPIN