Provider Demographics
NPI:1073310397
Name:RANDO, MORGAN (MT)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:RANDO
Suffix:
Gender:
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4-901 KUHIO HWY STE B
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-1549
Mailing Address - Country:US
Mailing Address - Phone:808-826-6000
Mailing Address - Fax:
Practice Address - Street 1:4-901 KUHIO HWY STE B
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1549
Practice Address - Country:US
Practice Address - Phone:808-826-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI17303225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist