Healthcare Provider Details

I. General information

NPI: 1710140231
Provider Name (Legal Business Name): SUSANNE MACSAY N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1628 E SOUTHERN AVE STE 4
TEMPE AZ
85282-5685
US

IV. Provider business mailing address

1628 E SOUTHERN AVE STE 4
TEMPE AZ
85282-5685
US

V. Phone/Fax

Practice location:
  • Phone: 480-231-4525
  • Fax:
Mailing address:
  • Phone: 480-231-4525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1345
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number08-1049
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: