# JENNA GRAVEN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689053589
- **Authorized official:** JENNA LEE GRAVEN LMT (OWNER/MASSAGE THERAPIST)
- **Authorized official phone:** (541) 292-6848

## Contact information

- **Practice address:** 2246 ALOHA AVE, MEDFORD, OR 97504-6938
- **Practice address phone:** (541) 292-6848
- **Mailing address:** 2246 ALOHA AVE, MEDFORD, OR 97504-6938

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 18121 | OR | Yes |

## Other

- **Enumeration date:** 05/25/2015
- **Last updated:** 05/25/2015