Provider Demographics
NPI:1336751643
Name:LAM, RACHELLE MARIE CHIEKO (BS OTR)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:MARIE CHIEKO
Last Name:LAM
Suffix:
Gender:F
Credentials:BS OTR
Other - Prefix:
Other - First Name:RACHELLE
Other - Middle Name:MARIE CHIEKO
Other - Last Name:SUNADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS OTR
Mailing Address - Street 1:1401 S BERETANIA ST STE 730
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1881
Mailing Address - Country:US
Mailing Address - Phone:808-593-2830
Mailing Address - Fax:808-593-2840
Practice Address - Street 1:94-1030 WAIPIO UKA ST STE 101
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4084
Practice Address - Country:US
Practice Address - Phone:808-677-4263
Practice Address - Fax:808-686-9605
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT135225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist