Provider Demographics
NPI:1811097710
Name:LUM, DORENE KAMAKANI (LMT)
Entity type:Individual
Prefix:
First Name:DORENE
Middle Name:KAMAKANI
Last Name:LUM
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:DORENE
Other - Middle Name:KAMAKANI
Other - Last Name:LUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:1650 LILIHA ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-3169
Mailing Address - Country:US
Mailing Address - Phone:808-398-1661
Mailing Address - Fax:808-841-1456
Practice Address - Street 1:1650 LILIHA ST
Practice Address - Street 2:SUITE 202
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3169
Practice Address - Country:US
Practice Address - Phone:808-398-1661
Practice Address - Fax:808-841-1456
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIH00170421225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist