Provider Demographics
NPI:1194260026
Name:TERLAJE, SIERRA (LICENSED PTA)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:TERLAJE
Suffix:
Gender:F
Credentials:LICENSED PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 S KING ST
Mailing Address - Street 2:UNIT 300
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2009
Mailing Address - Country:US
Mailing Address - Phone:180-834-8633
Mailing Address - Fax:
Practice Address - Street 1:1350 S KING ST
Practice Address - Street 2:UNIT 300
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2009
Practice Address - Country:US
Practice Address - Phone:180-834-8633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI168225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant