Provider Demographics
NPI:1285736645
Name:WEISS, KRISTI L (PT)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:L
Last Name:WEISS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:L
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:567 KAWAILOA RD
Mailing Address - Street 2:APT B
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3168
Mailing Address - Country:US
Mailing Address - Phone:808-421-9339
Mailing Address - Fax:
Practice Address - Street 1:40 AULIKE ST
Practice Address - Street 2:STE 416
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2757
Practice Address - Country:US
Practice Address - Phone:808-421-9339
Practice Address - Fax:808-442-0844
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-1709225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH101366Medicare PIN