Doctor Name: | TROY SACKETT |
NPI Number: | 1154751790 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMP |
License Number: | MA 60378614 |
Business Practice Address: | 11504 Se Mill Plain Blvd Ste 1-e Vancouver, WA - 986845081 |
Business Phone Number: | 3602543022 |
Business Fax Number: | |
Mailing Address: | 1000 Se 160th Ave Apt F37, VANCOUVER |
State: | WA |
Postal Code: | 986839685 |
Phone Number: | 3605675110 |
Fax Number: | |
NPI Enumeration Date: | 11/18/2013 |
NPI Last Update Date: | 11/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA 60378614 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |