Provider Demographics
NPI:1932352739
Name:THERAPEUTIC MASSAGE OF THE PACIFIC, LLC
Entity Type:Organization
Organization Name:THERAPEUTIC MASSAGE OF THE PACIFIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-566-6364
Mailing Address - Street 1:1188 BISHOP ST
Mailing Address - Street 2:SUITE 2009
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3301
Mailing Address - Country:US
Mailing Address - Phone:808-566-6364
Mailing Address - Fax:808-532-5150
Practice Address - Street 1:1188 BISHOP ST
Practice Address - Street 2:SUITE 2009
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3301
Practice Address - Country:US
Practice Address - Phone:808-566-6364
Practice Address - Fax:808-532-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAE 2278225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty