Provider Demographics
NPI:1659128460
Name:SACED TRIP MASSAGE
Entity type:Organization
Organization Name:SACED TRIP MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SATISOUK
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUCETT
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:510-384-5817
Mailing Address - Street 1:19401 N 15TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-3625
Mailing Address - Country:US
Mailing Address - Phone:510-384-5817
Mailing Address - Fax:
Practice Address - Street 1:13610 N SCOTTSDALE RD STE 15
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4053
Practice Address - Country:US
Practice Address - Phone:510-384-5817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1306691449
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)Group - Single Specialty