Healthcare Provider Details

I. General information

NPI: 1215850854
Provider Name (Legal Business Name): RUBY JUNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 MIRA MAR AVE
MEDFORD OR
97504-8546
US

IV. Provider business mailing address

400 W 4TH ST
PHOENIX OR
97535-5710
US

V. Phone/Fax

Practice location:
  • Phone: 541-857-7777
  • Fax:
Mailing address:
  • Phone: 551-574-0389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number10470
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: