Joseph Micketti, LMT
Individual provider Active NPI Massage Therapist · Ashland, OR
NPI 1801437157 · NPPES record last updated Oct 7, 2019
Key facts
- NPI
- 1801437157
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 4348 (OR)
- Practice address
- 279 Liberty St
Ashland, OR 97520-2901 - Phone
- (541) 482-0413
- NPI assigned
- Oct 7, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4348 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Myotherapy | Massage Therapist | Current |
Accepting new patients |
Locations
1467 Siskiyou Blvd
Ashland, OR 97520
Phone (541) 200-5743
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 4348 | OR | Yes |
Addresses
Primary practice location
279 Liberty St
Ashland, OR 97520-2901
Mailing address
1467 Siskiyou Blvd # 53
Ashland, OR 97520-2336
Phone (541) 482-0413
Other providers in Ashland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.