Healthcare Provider Details

I. General information

NPI: 1700709748
Provider Name (Legal Business Name): CHASITY SALVADOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 PINON STREET 505
ACOMA NM
87034-1234
US

IV. Provider business mailing address

PO BOX 629
ACOMA NM
87034-0629
US

V. Phone/Fax

Practice location:
  • Phone: 505-658-1114
  • Fax:
Mailing address:
  • Phone: 505-658-1114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT-2025-0251
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: