Provider Demographics
NPI:1063388494
Name:OYADOMARI, LAVENDER NOEL (RD)
Entity type:Individual
Prefix:
First Name:LAVENDER NOEL
Middle Name:
Last Name:OYADOMARI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 NUUANU AVE APT 1702
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2540
Mailing Address - Country:US
Mailing Address - Phone:808-779-3610
Mailing Address - Fax:
Practice Address - Street 1:2029 NUUANU AVE APT 1702
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2540
Practice Address - Country:US
Practice Address - Phone:808-779-3610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered