OrganizationActive
111th Square Fitness and Therapy, LLC
NPI 1750521985 · Physical Therapist · Portland, OR
Provider details
- NPI number
- 1750521985
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Authorized official
- Linda Sanchez, Maker
- License
- 15397 (OR)
Practice location
11126 Ne Halsey St
Portland, OR 97220-2021
Phone: (503) 256-5200
Fax: (503) 253-7958
Mailing address
11126 Ne Halsey St
Portland, OR 97220-2021
Registry dates
- Enumerated
- 2009-02-27
- Last updated
- 2009-02-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.