Individual
KENYA MICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1825 NEBRASKA AVE, GRANTS PASS, OR 97527-5701
(541) 425-6254
Mailing address
1825 NEBRASKA AVE, GRANTS PASS, OR 97527-5701
(541) 425-6254
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28435
OR
Other
Enumeration date
01/16/2026
Last updated
01/16/2026
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