Provider Demographics
NPI:1174903900
Name:LOS BANOS, HELENE MICHELE (LMT)
Entity type:Individual
Prefix:MRS
First Name:HELENE
Middle Name:MICHELE
Last Name:LOS BANOS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 LAKAU PL
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7629
Mailing Address - Country:US
Mailing Address - Phone:808-298-3195
Mailing Address - Fax:
Practice Address - Street 1:275 LAKAU PL
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7629
Practice Address - Country:US
Practice Address - Phone:808-298-3195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-06
Last Update Date:2015-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI8989173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist