Basic Information
Provider Information
NPI: 1972030245
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARIOS
FirstName: NATHALIE JUNE
MiddleName: DELA CRUZ
NamePrefix:  
NameSuffix:  
Credential: LMT
OtherOrganizationName:  
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OtherLastName:  
OtherFirstName:  
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OtherCredential:  
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Mailing Information
Address1: 91-1027 SHANGRILA ST BLDG 1867
Address2:  
City: KAPOLEI
State: HI
PostalCode: 967072101
CountryCode: US
TelephoneNumber: 8086749595
FaxNumber: 8086749696
Practice Location
Address1: 91-1027 SHANGRILA ST BLDG 1867
Address2:  
City: KAPOLEI
State: HI
PostalCode: 967072101
CountryCode: US
TelephoneNumber: 8086749595
FaxNumber: 8086749696
Other Information
ProviderEnumerationDate: 05/17/2017
LastUpdateDate: 05/17/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225700000X4829HIY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist 

No ID Information.


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