Individual provider · Type 1 NPI

Jordan K. Deharty, LMT

Massage Therapist · Grants Pass, OR

NPI number 1629680657 Active

Practice location

333 SW 5th St
Grants Pass, OR 97526-2509

Call (541) 507-9894 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X21792 (OR)

Massage Therapist: 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.

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About NPI 1629680657

Jordan K. Deharty, LMT's National Provider Identifier is 1629680657, issued on Aug 20, 2020. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Grants Pass, OR. The record was last updated on Aug 20, 2020.