Individual provider Active NPI

Tavish Lee Demayo

  • Massage Therapist
  • Kailua Kona, HI
National Provider Identifier
1053277749
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
18229 Issued in HI
Practice address
75-5783 Kawena St
Kailua Kona, HI 96740-2067
Phone
(928) 606-5435
NPI assigned
Dec 26, 2025
Last updated
Dec 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 18229 HI Primary

Addresses

Primary practice location

75-5783 Kawena St
Kailua Kona, HI 96740-2067

Mailing address

75-5783 Kawena St
Kailua Kona, HI 96740-2067
Phone (928) 606-5435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18229HIMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1766707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766707200000",
    "number": "1053277749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5783 KAWENA ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402067",
            "telephone_number": "928-606-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5783 KAWENA ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402067",
            "telephone_number": "928-606-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMAYO",
        "first_name": "TAVISH",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-26",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "18229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.