Provider Demographics
NPI:1881113165
Name:SHIMABUKURO-ARAKI, GINA
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:SHIMABUKURO-ARAKI
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 1:1581 HOOLAULEA ST
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-2143
Mailing Address - Country:US
Mailing Address - Phone:808-600-5583
Mailing Address - Fax:
Practice Address - Street 1:3558 WOODLAWN DR APT A
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-1494
Practice Address - Country:US
Practice Address - Phone:808-554-0611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-18
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT-88225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist