Provider Demographics
NPI:1992471866
Name:MASONER, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MASONER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 542
Mailing Address - Street 2:
Mailing Address - City:HONAUNAU
Mailing Address - State:HI
Mailing Address - Zip Code:96726-0542
Mailing Address - Country:US
Mailing Address - Phone:808-443-1995
Mailing Address - Fax:
Practice Address - Street 1:75-5719 ALII DR STE 116
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1712
Practice Address - Country:US
Practice Address - Phone:808-557-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-16575225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist