Provider Demographics
NPI:1316126642
Name:ARAKAKI, MARY JEAN (RD)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:JEAN
Last Name:ARAKAKI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 ULUKAHIKI ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4400
Mailing Address - Country:US
Mailing Address - Phone:808-263-5053
Mailing Address - Fax:808-263-5054
Practice Address - Street 1:642 ULUKAHIKI ST
Practice Address - Street 2:SUITE 105
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-4400
Practice Address - Country:US
Practice Address - Phone:808-263-5053
Practice Address - Fax:808-263-5054
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000247478OtherHMSA