Provider Demographics
NPI:1306601240
Name:WAITE, FRANCES ADRIENNE (LMT)
Entity type:Individual
Prefix:MRS
First Name:FRANCES
Middle Name:ADRIENNE
Last Name:WAITE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:FRANCES
Other - Middle Name:ADRIENNE
Other - Last Name:ODOSHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 631217
Mailing Address - Street 2:
Mailing Address - City:LANAI CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96763-1217
Mailing Address - Country:US
Mailing Address - Phone:808-649-0317
Mailing Address - Fax:
Practice Address - Street 1:520 JACARANDA STREET
Practice Address - Street 2:
Practice Address - City:LANAI CITY
Practice Address - State:HI
Practice Address - Zip Code:96763
Practice Address - Country:US
Practice Address - Phone:808-649-0317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI14313225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist