# PAKOLEA REHAB

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164836870
- **Authorized official:** SHAUNA RUSSELL DPT (OWNER)
- **Authorized official phone:** (808) 553-5199

## Contact information

- **Practice address:** 135 S WAKEA AVE, KAHULUI, HI 96732-1385
- **Practice address phone:** (808) 553-5199
- **Mailing address:** 135 S WAKEA AVE, KAHULUI, HI 96732-1385

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225400000X | Rehabilitation Practitioner | AT-212 | HI | Yes |

## Other

- **Enumeration date:** 06/20/2014
- **Last updated:** 06/20/2014