Provider Demographics
NPI:1588929228
Name:STRAUWALD, AMANDA LOUISE (DPT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LOUISE
Last Name:STRAUWALD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5281 IHILANI PL
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-2528
Mailing Address - Country:US
Mailing Address - Phone:909-228-2436
Mailing Address - Fax:
Practice Address - Street 1:5281 IHILANI PL
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-2528
Practice Address - Country:US
Practice Address - Phone:909-228-2436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI34292251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics