Provider Demographics
NPI:1316311921
Name:CAMACHO, ROY RICHARD (PT, DPT, MHA, OCS)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:RICHARD
Last Name:CAMACHO
Suffix:
Gender:
Credentials:PT, DPT, MHA, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:683 WAIANAE AVENUE, BLDG 674
Mailing Address - Street 2:DESMOND T. DOSS ARMY HEALTH CENTER, SPORTS MEDICINE
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786
Mailing Address - Country:US
Mailing Address - Phone:808-433-8031
Mailing Address - Fax:
Practice Address - Street 1:683 WAIANAE AVENUE, BLDG 674
Practice Address - Street 2:DESMOND T. DOSS ARMY HEALTH CENTER, SPORTS MEDICINE
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786
Practice Address - Country:US
Practice Address - Phone:808-433-8031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-19
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-5914225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist