Healthcare Provider Details

I. General information

NPI: 1497998603
Provider Name (Legal Business Name): KEITH SACCO N.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 04/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17917 95TH PL NE APT 303
BOTHELL WA
98011-2603
US

IV. Provider business mailing address

17917 95TH PL NE APT 303
BOTHELL WA
98011-2603
US

V. Phone/Fax

Practice location:
  • Phone: 206-427-7492
  • Fax:
Mailing address:
  • Phone: 206-427-7492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60056369
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: