Provider Demographics
NPI:1154587848
Name:SASAKI, STEPHEN (LMT)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:SASAKI
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-1062 MELE ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4340
Mailing Address - Country:US
Mailing Address - Phone:808-677-7512
Mailing Address - Fax:
Practice Address - Street 1:94-1062 MELE ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4340
Practice Address - Country:US
Practice Address - Phone:808-677-7512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10467225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist