JORDAN K DEHARTY (NPI# 1629680657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629680657 |
| Entity Type | Individual |
| Full Name | JORDAN K DEHARTY |
| Credential | LMT |
| Practice Address |
333 Sw 5th St Grants Pass OR 97526-2509 |
| Practice Telephone | 5415079894 |
| Mailing Telephone | 5415079894 |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2020-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 21792 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
333 SW 5TH ST |
| City | GRANTS PASS |
| State | OR |
| Zip Code | 97526-2509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023024262 | Ryan C Baker | Chiropractor | 333 Sw 5th St, Suite B, Grants Pass, OR 97526-2513 | 2006-07-31 |
| 1619589579 | Sherri L. Red | Massage Therapist | 333 Sw 5th St, Grants Pass, OR 97526-2509 | 2020-08-20 |
| 1457963324 | Andrew Whitman | Physical Therapist | 333 Sw 5th St, Grants Pass, OR 97526-2509 | 2020-08-20 |
| 1154933182 | Keith T Townsel | Massage Therapist | 333 Sw 5th St, Grants Pass, OR 97526-2509 | 2020-08-20 |
| 1407468440 | Jessyka Vandernick | Massage Therapist | 333 Sw 5th St, Grants Pass, OR 97526-2509 | 2020-08-20 |
| 1861004723 | Regina K. O'brien | Massage Therapist | 333 Sw 5th St, Grants Pass, OR 97526-2509 | 2020-08-20 |
| 1841820727 | Samuel Thompson | Massage Therapist | 333 Sw 5th St, Grants Pass, OR 97526-2509 | 2020-01-20 |
| 1336203835 | Ryan Baker, D.c. P.C. | Chiropractor | 333 Sw 5th St, Suite B, Grants Pass, OR 97526-2513 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205476777 | Kyla M Mccormick | Peer Specialist | 109 Nw Manzanita Avenue, Grants Pass, OR 97526 | 2020-01-13 |
| 1164076469 | Alicia Yvonne Hansen | Counselor | 1055 Clarey St., Grants Pass, OR 97526 | 2019-07-25 |
| 1841842598 | Michael Liam Reynolds, Dds, LLC | Dentist | 984 Ne 8th Street, Grants Pass Oregon, Grants Pass, OR 97526 | 2019-07-12 |
| 1881254746 | Brandi Mccrorey | Counselor | 418 Ne 6th Street, Suite 102, Grants Pass, OR 97526 | 2019-06-13 |
| 1700364502 | Premier Community Supports, LLC. | Day Training, Developmentally Disabled Services | 1439 Ne 6th St Ste C, Grants Pass, OR 97526 | 2018-08-02 |
| 1821584509 | Stefani Mcintyre | Massage Therapist | 1590 Se N Street, Warehouse #1574, Grants Pass, OR 97526 | 2018-07-06 |
| 1114467438 | Sandra P Martin | Chiropractor | 333 Sw 5th St. Suite B, Grants Pass, OR 97526 | 2017-03-06 |
| 1801347612 | Maci Wageman | Counselor | 1215 Sw G St Grants Pass Oregon 97526, Grants Pass, OR 97526 | 2016-10-17 |
| 1902353907 | Optimal Health of Southern Oregon, LLC | Family Medicine | 1600 Nw 6th St South Suite, Grants Pass, OR 97526 | 2016-09-07 |
| 1982150793 | Tanya White | Counselor | 402 Nw Fstreet, Grants Pass, OR 97526 | 2016-08-31 |
| Find all providers in zip 97526 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023656659 | Wesley William Molsberry | Massage Therapist | 1051 Ne 6th St Ste B, Grants Pass, OR 97526-1190 | 2019-12-13 |
| 1780230698 | Beth Warren | Massage Therapist | 315 Se 7th St Ste B, Grants Pass, OR 97526-3002 | 2019-08-15 |
| 1356807168 | Jessica Dawn Rousseau | Massage Therapist | 202 Redwood Hwy, Grants Pass, OR 97527-5454 | 2019-02-17 |
| 1740750991 | Mckenzie Lee Millette | Massage Therapist | 111 Sw H St # 8, Grants Pass, OR 97526-2505 | 2018-11-30 |
| 1235606229 | Anthony River Monize | Massage Therapist | 124 Nw D St, Grants Pass, OR 97526-2008 | 2018-10-28 |
| 1669957296 | Alix Michele Marmulstein | Massage Therapist | 220 Se H St Ste 5, Grants Pass, OR 97526-3025 | 2018-09-28 |
| 1821584509 | Stefani Mcintyre | Massage Therapist | 1590 Se N Street, Warehouse #1574, Grants Pass, OR 97526 | 2018-07-06 |
| 1003311499 | Valerie Schlaht | Massage Therapist | 220 Se H St Ste 5b, Grants Pass, OR 97526-3025 | 2018-03-27 |
| 1720501026 | Kelly Bates | Massage Therapist | 501 Cheney Creek Rd, Grants Pass, OR 97527 | 2017-07-19 |
| 1639608474 | Malialani Burton | Massage Therapist | 304 Ne Agness Ave, Grants Pass, OR 97526-7902 | 2017-06-06 |
| Find all providers in GRANTS PASS | ||||
| City | GRANTS PASS |
| Zip Code | 97526 |
Please comment or provide details below to improve the information on JORDAN K DEHARTY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.