Provider Demographics
NPI:1194451229
Name:MIYOGA, RACHEL (DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:MIYOGA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-1187 HALELAUKOA DR
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-6211
Mailing Address - Country:US
Mailing Address - Phone:808-277-2885
Mailing Address - Fax:
Practice Address - Street 1:99-128 AIEA HEIGHTS DRIVE
Practice Address - Street 2:#207
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3968
Practice Address - Country:US
Practice Address - Phone:808-487-0487
Practice Address - Fax:808-486-8674
Is Sole Proprietor?:No
Enumeration Date:2022-07-29
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
HIPT5512225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist