Provider Demographics
NPI:1699429068
Name:PATTERSON, LAURA CATHERINE (LMT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:CATHERINE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:752 KAUMANA DR
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-1817
Mailing Address - Country:US
Mailing Address - Phone:808-938-9683
Mailing Address - Fax:
Practice Address - Street 1:400 HUALANI ST STE 191B
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4339
Practice Address - Country:US
Practice Address - Phone:808-938-9683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI7673225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist