Healthcare Provider Details

I. General information

NPI: 1699407072
Provider Name (Legal Business Name): SATORI HEALING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2022
Last Update Date: 06/25/2022
Certification Date: 06/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 TRINITY DR STE C3
LOS ALAMOS NM
87544-2221
US

IV. Provider business mailing address

1040 PINON LOOP
LOS ALAMOS NM
87544-2962
US

V. Phone/Fax

Practice location:
  • Phone: 505-500-8213
  • Fax: 505-485-0511
Mailing address:
  • Phone: 505-709-8782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK A MARTIN
Title or Position: OWNER/CEO
Credential: MD
Phone: 505-709-8782