Provider Demographics
NPI:1982923520
Name:BORASH, DONNELL L (DAOM, LAC)
Entity Type:Individual
Prefix:DR
First Name:DONNELL
Middle Name:L
Last Name:BORASH
Suffix:
Gender:F
Credentials:DAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68-051 AKULE ST
Mailing Address - Street 2:#205
Mailing Address - City:WAIALUA
Mailing Address - State:HI
Mailing Address - Zip Code:96791-9447
Mailing Address - Country:US
Mailing Address - Phone:512-619-3853
Mailing Address - Fax:
Practice Address - Street 1:68-051 AKULE ST
Practice Address - Street 2:#201
Practice Address - City:WAIALUA
Practice Address - State:HI
Practice Address - Zip Code:96791-9447
Practice Address - Country:US
Practice Address - Phone:512-619-3853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9252171100000X
TXAC01342171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN