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Individual

DR. SHAUNA KA'IULANI RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.P.T.

Contact information

Practice address
740 KILAUEA AVE, HILO, HI 96720-4234
(808) 935-5255
(808) 961-9044
Mailing address
PO BOX 6783, HILO, HI 96720-8934
(808) 935-5255
(808) 961-9044

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3052
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
289389
HMSA
HI
Enumeration date
04/25/2007
Last updated
08/23/2022
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