Provider Demographics
NPI:1548645393
Name:VELASQUEZ, DIONISIO VINLUAN (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MR
First Name:DIONISIO
Middle Name:VINLUAN
Last Name:VELASQUEZ
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:775 MCNEILL ST. #118-B
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4218
Mailing Address - Country:US
Mailing Address - Phone:808-391-9585
Mailing Address - Fax:808-841-0247
Practice Address - Street 1:2041-B NORTH KING ST.
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4218
Practice Address - Country:US
Practice Address - Phone:808-391-9585
Practice Address - Fax:808-841-0247
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMAT-6126225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist