Provider Demographics
NPI:1144343211
Name:WATTS, LORNA SALCEDO (LMT)
Entity type:Individual
Prefix:
First Name:LORNA
Middle Name:SALCEDO
Last Name:WATTS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 LILIHA STREET
Mailing Address - Street 2:SUITE #501B
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817
Mailing Address - Country:US
Mailing Address - Phone:808-531-0022
Mailing Address - Fax:808-531-0023
Practice Address - Street 1:1520 LILIHA STREET
Practice Address - Street 2:SUITE #501B
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-531-0022
Practice Address - Fax:808-531-0023
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT8428225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIMAT8428OtherBOARD OF MASSAGE
HI1063833OtherHMSA