Healthcare Provider Details

I. General information

NPI: 1982156378
Provider Name (Legal Business Name): SAJA LYNN L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2016
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3133 E GREENWAY RD STE 505
PHOENIX AZ
85032-4480
US

IV. Provider business mailing address

12810 N 29TH ST
PHOENIX AZ
85032-6507
US

V. Phone/Fax

Practice location:
  • Phone: 480-336-3504
  • Fax:
Mailing address:
  • Phone: 602-348-6037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1048
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: