Provider Demographics
NPI:1497998603
Name:SACCO, KEITH (ND)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:
Last Name:SACCO
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17917 95TH PL NE APT 303
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-2603
Mailing Address - Country:US
Mailing Address - Phone:206-427-7492
Mailing Address - Fax:
Practice Address - Street 1:17917 95TH PL NE APT 303
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-2603
Practice Address - Country:US
Practice Address - Phone:206-427-7492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60056369175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath