Provider Demographics
NPI:1154400422
Name:OSTERLUND, LENA (PT)
Entity type:Individual
Prefix:
First Name:LENA
Middle Name:
Last Name:OSTERLUND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 S KING ST
Mailing Address - Street 2:SUITE 506
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2506
Mailing Address - Country:US
Mailing Address - Phone:808-955-5560
Mailing Address - Fax:808-955-5580
Practice Address - Street 1:1451 S KING ST
Practice Address - Street 2:SUITE 506
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2506
Practice Address - Country:US
Practice Address - Phone:808-955-5560
Practice Address - Fax:808-955-5580
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1019225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI6880402Medicaid
HI54810Medicare ID - Type Unspecified