IndividualActive
Desiree Mata, PT
NPI 1235598392 · Physical Therapist · Grants Pass, OR
Provider details
- NPI number
- 1235598392
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PT
- Sex
- Female
- Sole proprietor
- No
- License
- 06567 (OR)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1710 Ne Fairview Ave
Grants Pass, OR 97526-3877
Phone: (541) 479-2606
Approximate (ZIP-level) locationGet directions
Mailing address
406 Ne Silverwood Pl
Grants Pass, OR 97526-2226
Registry dates
- Enumerated
- 2016-02-17
- Last updated
- 2016-02-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.