Provider Demographics
NPI:1699796425
Name:WATANABE, CURT K (DPT)
Entity type:Individual
Prefix:
First Name:CURT
Middle Name:K
Last Name:WATANABE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 KAMEHAMEHA HWY
Mailing Address - Street 2:SUITE 167C
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-2656
Mailing Address - Country:US
Mailing Address - Phone:808-454-2285
Mailing Address - Fax:808-454-1334
Practice Address - Street 1:850 KAMEHAMEHA HWY
Practice Address - Street 2:SUITE 167C
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-2656
Practice Address - Country:US
Practice Address - Phone:808-454-2285
Practice Address - Fax:808-454-1334
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI972225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00K79794OtherHMSA
HI00K79794OtherHMSA
HIH54843Medicare ID - Type Unspecified