Individual
MR. RUSSELL KIYOSHI YAMADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1650 LILIHA ST STE 107, HONOLULU, HI 96817-3169
(808) 536-6117
(808) 587-7727
Mailing address
1650 LILIHA ST STE 107, HONOLULU, HI 96817-3169
(808) 536-6117
(808) 587-7727
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
857
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49315601
—
HI
Enumeration date
10/12/2006
Last updated
07/08/2007
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