Provider Demographics
NPI:1487111761
Name:KANE, TENISHA K (LMT)
Entity type:Individual
Prefix:MRS
First Name:TENISHA
Middle Name:K
Last Name:KANE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:TENISHA
Other - Middle Name:K
Other - Last Name:RUIDAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-0309
Mailing Address - Country:US
Mailing Address - Phone:808-633-6167
Mailing Address - Fax:808-830-2203
Practice Address - Street 1:1525 KALAKAUA AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-2409
Practice Address - Country:US
Practice Address - Phone:808-633-6167
Practice Address - Fax:808-830-2203
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-22
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI15385225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist