Individual
MS. IVY JOAN MEDOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L, CRC
Contact information
Practice address
1657 36TH ST, FLORENCE, OR 97439-8922
(480) 837-4565
Mailing address
1657 36TH ST, FLORENCE, OR 97439-8922
(480) 229-6244
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C-6670
OR
225700000X
Massage Therapist
25705
OR
Other
Enumeration date
08/03/2011
Last updated
10/16/2025
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