Provider Demographics
NPI:1992422570
Name:UYENO, RYAN KAZUTOSHI (DPT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:KAZUTOSHI
Last Name:UYENO
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 1:677 ALA MOANA BLVD STE 725
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5417
Mailing Address - Country:US
Mailing Address - Phone:808-734-0010
Mailing Address - Fax:808-734-0013
Practice Address - Street 1:677 ALA MOANA BLVD STE 725
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5417
Practice Address - Country:US
Practice Address - Phone:808-734-0010
Practice Address - Fax:808-734-0013
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-5524225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIPT-5524OtherHAWAII STATE PHYSICAL THERAPY LICENSE PT-5524