Provider Demographics
NPI:1427271055
Name:YONESHIGE, AUDREY MITSUKO (PT)
Entity type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:MITSUKO
Last Name:YONESHIGE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:AUDREY
Other - Middle Name:MITSUKO
Other - Last Name:SHIMOKAWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4540 ALIIKOA STREET
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821
Mailing Address - Country:US
Mailing Address - Phone:808-623-4840
Mailing Address - Fax:
Practice Address - Street 1:1907 SOUTH BERETANIA ST
Practice Address - Street 2:ARTESIAN PLAZA FIRST FLOOR KAPIOLANI WOMENS CENTER
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826
Practice Address - Country:US
Practice Address - Phone:808-973-6540
Practice Address - Fax:808-973-6537
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI365225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist