Provider Demographics
NPI:1982156378
Name:LYNN, SAJA (LAC)
Entity Type:Individual
Prefix:
First Name:SAJA
Middle Name:
Last Name:LYNN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12810 N 29TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-6507
Mailing Address - Country:US
Mailing Address - Phone:602-348-6037
Mailing Address - Fax:
Practice Address - Street 1:3133 E GREENWAY RD STE 505
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4480
Practice Address - Country:US
Practice Address - Phone:480-336-3504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1048171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist