Andrea Lynn Henke, LMT
Individual provider Active NPI Massage Therapist · Pahoa, HI
NPI 1194422980 · NPPES record last updated Feb 13, 2023
Key facts
- NPI
- 1194422980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 7155 (HI)
- Practice address
- 15-681 Kahakai Blvd
Pahoa, HI 96778-9559 - Phone
- (808) 657-7568
- NPI assigned
- Feb 13, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0014713 | CO | MD | Professional Counselor |
| 7155 | HI | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 0014713 | CO | |
| Massage Therapist | 225700000X | 7155 | HI | Yes |
Addresses
Primary practice location
15-681 Kahakai Blvd
Pahoa, HI 96778-9559
Mailing address
15-681 Kahakai Blvd
Pahoa, HI 96778-9559
Phone (808) 657-7568
Other providers in Pahoa, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.