Provider Demographics
NPI:1598541450
Name:ISHII, MATTHEW B K (PT, DPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:B K
Last Name:ISHII
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 1:629 HAO STREET
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-1617
Mailing Address - Country:US
Mailing Address - Phone:808-428-9168
Mailing Address - Fax:
Practice Address - Street 1:99-128 AIEA HEIGHTS DRIVE
Practice Address - Street 2:#207
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3968
Practice Address - Country:US
Practice Address - Phone:808-487-0487
Practice Address - Fax:808-486-8674
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT6140225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist