Individual provider Active NPI

Nathaniel U D Yesan, LMT

  • Massage Therapist
  • Lihue, HI
National Provider Identifier
1780702308
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
6301 Issued in HI
Practice address
4268 Rice St Ste J
Lihue, HI 96766-1318
Phone
(808) 652-2946
Fax
(808) 652-2946
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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 6301 HI Primary

Addresses

Primary practice location

4268 Rice St Ste J
Lihue, HI 96766-1318

Mailing address

PO Box 1894
Lihue, HI 96766-5894
Phone (808) 652-2946

Other names 1

  • Nathan U D Yesan Professional name

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
6301HIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1780702308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1894",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967665894",
            "telephone_number": "808-652-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4268 RICE ST STE J",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "967661318",
            "telephone_number": "808-652-2946",
            "fax_number": "808-652-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YESAN",
        "first_name": "NATHANIEL",
        "middle_name": "U D",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "6301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATHAN",
            "last_name": "YESAN",
            "middle_name": "U D",
            "credential": "LMT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lihue, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.