Provider Demographics
NPI:1801176524
Name:SEIBER, OCATILLA (LMT)
Entity type:Individual
Prefix:
First Name:OCATILLA
Middle Name:
Last Name:SEIBER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:PAAUILO
Mailing Address - State:HI
Mailing Address - Zip Code:96776-0400
Mailing Address - Country:US
Mailing Address - Phone:503-764-8376
Mailing Address - Fax:
Practice Address - Street 1:45-3490 MAMANE ST
Practice Address - Street 2:
Practice Address - City:HONOKAA
Practice Address - State:HI
Practice Address - Zip Code:96727-6943
Practice Address - Country:US
Practice Address - Phone:503-764-8376
Practice Address - Fax:808-443-0323
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16124225700000X
HI16823225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist