Provider Demographics
NPI:1740800549
Name:ARAKAWA, AMANDA (ATC, ROT, CES)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:ARAKAWA
Suffix:
Gender:F
Credentials:ATC, ROT, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:456 WAINEE ST
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-1108
Mailing Address - Country:US
Mailing Address - Phone:808-281-3806
Mailing Address - Fax:
Practice Address - Street 1:411 E SE LOOP 323
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-9633
Practice Address - Country:US
Practice Address - Phone:903-262-2625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer