Provider Demographics
NPI:1467295188
Name:BOWEN, DANIELLE EARLANA (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:EARLANA
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 KINOOLE ST STE 120
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3811
Mailing Address - Country:US
Mailing Address - Phone:541-357-2620
Mailing Address - Fax:
Practice Address - Street 1:688 KINOOLE ST STE 120
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3811
Practice Address - Country:US
Practice Address - Phone:541-357-2620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI14477225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist