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Individual

MS. TANYA L RAYMOND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, LMT

Contact information

Practice address
36 KAULUA PL, PAIA, HI 96779-9719
(808) 351-4322
(808) 757-9391
Mailing address
36 KAULUA PL, PAIA, HI 96779-9719
(808) 351-4322
(808) 757-9391

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
583
HI
225100000X
Physical Therapist
Primary
PT583
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00M0091779
HMSA
HI
05
07058601
HI
01
M09177-9
HMSA
HI
Enumeration date
06/16/2006
Last updated
03/15/2017
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