Provider Demographics
NPI:1538239975
Name:MORIMOTO, LYNN S (DAC, LMT)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:S
Last Name:MORIMOTO
Suffix:
Gender:F
Credentials:DAC, LMT
Other - Prefix:DR
Other - First Name:LYNA
Other - Middle Name:S
Other - Last Name:MORIMOTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DAC, LMT
Mailing Address - Street 1:1150 S KING ST STE 507
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1952
Mailing Address - Country:US
Mailing Address - Phone:808-591-9310
Mailing Address - Fax:808-597-8873
Practice Address - Street 1:1150 S KING ST STE 507
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1952
Practice Address - Country:US
Practice Address - Phone:808-591-9310
Practice Address - Fax:808-597-8873
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI324171100000X
HI2186174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI2186OtherLICENSED MASSAGE THERAPIS
HI324OtherLICENSED ACUPUNCTURIST