Provider Demographics
NPI:1073658977
Name:WEST, NYKOL (LMT)
Entity type:Individual
Prefix:
First Name:NYKOL
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 812
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-0812
Mailing Address - Country:US
Mailing Address - Phone:808-322-0048
Mailing Address - Fax:808-322-0048
Practice Address - Street 1:75-5744 ALII DR STE 249
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1740
Practice Address - Country:US
Practice Address - Phone:808-322-0048
Practice Address - Fax:808-322-0048
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4191225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist