Junne Licata

Physical Therapy Assistant · Medford, OR

Individual Active NPI

NPI number 1295386639

Practice location

1200 Mira Mar Ave
Medford, OR 97504-8546
Phone
(541) 857-7131

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NPI record

NPI
1295386639
Entity type
Individual (Type 1)
Enumeration date
September 26, 2019
Last updated
September 26, 2019
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapy Assistant Primary 225200000X 09803 OR

Mailing address

4560 SE International Way Ste 100
Milwaukie, OR 97222-4628

About Junne Licata

Junne Licata is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapy Assistant (code 225200000X). The practice location is 1200 Mira Mar Ave, Medford, OR 97504-8546. The NPI number 1295386639 was assigned on September 26, 2019 and the record was last updated on September 26, 2019.

Junne Licata lists a license in the registry: #09803 (OR) for Physical Therapy Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Junne Licata?

The NPI number is 1295386639.

What is the phone number of Junne Licata?

The phone number listed for the practice location is (541) 857-7131.

Where is Junne Licata located?

1200 Mira Mar Ave, Medford, OR 97504-8546.

What is the taxonomy code for Junne Licata?

The primary taxonomy code is 225200000X – Physical Therapy Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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