Provider Demographics
NPI:1760721898
Name:SALUTOGENICS
Entity Type:Organization
Organization Name:SALUTOGENICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MASA
Authorized Official - Middle Name:
Authorized Official - Last Name:SASAGAWA
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:801-808-6736
Mailing Address - Street 1:710 N 160TH ST
Mailing Address - Street 2:B214
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-5685
Mailing Address - Country:US
Mailing Address - Phone:801-808-6736
Mailing Address - Fax:
Practice Address - Street 1:710 N 160TH ST
Practice Address - Street 2:B214
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-5685
Practice Address - Country:US
Practice Address - Phone:801-808-6736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT1279261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care