Provider Demographics
NPI:1386897320
Name:KUNEWA, JEANNE KAUILANI
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:KAUILANI
Last Name:KUNEWA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 NE RIDDELL RD
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3035
Mailing Address - Country:US
Mailing Address - Phone:360-373-2225
Mailing Address - Fax:360-373-4767
Practice Address - Street 1:991 NE RIDDELL RD
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3035
Practice Address - Country:US
Practice Address - Phone:360-373-2225
Practice Address - Fax:360-373-4767
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024314225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist