Provider Demographics
NPI:1548880834
Name:YASUMOTO, SCOTT TAKESHI (PT, DPT)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:TAKESHI
Last Name:YASUMOTO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-1144 KA UKA BLVD STE 16
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4483
Mailing Address - Country:US
Mailing Address - Phone:808-531-2244
Mailing Address - Fax:808-490-0970
Practice Address - Street 1:94-1144 KA UKA BLVD STE 16
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4483
Practice Address - Country:US
Practice Address - Phone:808-531-2244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist