111TH Square Fitness And Therapy, LLC
Physical Therapist in Portland, Oregon
1750521985- Practice location
- 11126 NE Halsey St, Portland, OR 97220-2021
- Phone
- 503-256-5200
- Fax
- 503-253-7958
- Last updated
- February 27, 2009
111TH Square Fitness And Therapy, LLC is a healthcare organization based in Portland, OR. The NPI number for 111TH Square Fitness And Therapy, LLC is 1750521985 and holds license No. 15397 (OR). The current practice location address is 11126 NE Halsey St, Portland, OR 97220-2021 and the office can be reached by phone at 503-256-5200 and by fax at 503-253-7958. The NPI was assigned on February 27, 2009 and the record was last updated in NPPES on February 27, 2009.
●Provider Profile Details
- NPI Number
- 1750521985
- Provider Name
- 111TH Square Fitness And Therapy, LLC
- Entity Type
- Organization (Type 2 NPI)
- Primary Taxonomy
- Physical Therapist · 225100000X
- Organization Subpart
- No
- Authorized Official
- Ms. Linda Josephine Sanchez · Maker · 503-256-5200
- Enumeration Date
- February 27, 2009
- Last Update Date
- February 27, 2009
- NPI Status
- Active
◉Business Practice Location Address
- Address
- 11126 NE Halsey St
Portland, OR 97220-2021 - City
- Portland
- State
- Oregon
- ZIP
- 97220-2021
- Country
- US
- Phone Number
- 503-256-5200
- Fax Number
- 503-253-7958
✉Business Mailing Address
- Address
- 11126 NE Halsey St
Portland, OR 97220-2021 - City
- Portland
- State
- OR
- ZIP
- 97220-2021
- Phone Number
- 503-256-5200
- Fax Number
- 503-253-7958
✎Taxonomy & License Information
| Taxonomy | Code | Primary | License | State |
|---|---|---|---|---|
| Massage Therapist 193200000X - Multi-Specialty Group | 225700000X | No | 15397 | OR |
| Specialist/Technologist, Athletic Trainer 193200000X - Multi-Specialty Group | 2255A2300X | No | 1333261 | OR |
| Physical Therapist 193200000X - Multi-Specialty Group | 225100000X | Yes | 0355 | OR |
#Other Provider Identifiers
No legacy or other identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.
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View all providers in Portland →?Frequently Asked Questions
What is the NPI number of 111TH Square Fitness And Therapy, LLC?
The NPI number of 111TH Square Fitness And Therapy, LLC is 1750521985. It was assigned on February 27, 2009 and is currently active in the NPPES registry.
What is the specialty of 111TH Square Fitness And Therapy, LLC?
111TH Square Fitness And Therapy, LLC is registered under the primary taxonomy Physical Therapist (code 225100000X) and holds license No. 15397 (OR).
Where does 111TH Square Fitness And Therapy, LLC practice?
The practice location is 11126 NE Halsey St, Portland, OR 97220-2021. The office can be reached at 503-256-5200 (phone) or 503-253-7958 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1750521985 directly on the NPPES registry website at npiregistry.cms.hhs.gov.