Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

111th Square Fitness and Therapy, LLC

Organization Physical Therapist · NPI 1750521985

111th Square Fitness and Therapy, LLC is a Physical Therapist in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2009.

Licensed in
OR
In the registry since
2009
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11126 NE Halsey St
Portland, OR 97220-2021
Phone: (503) 256-5200
Fax: (503) 253-7958
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 0355 (OR)
Athletic Trainer Taxonomy 2255A2300X · Licence 1333261 (OR)
Massage Therapist Taxonomy 225700000X · Licence 15397 (OR)

Record details

NPI number1750521985
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Linda Sanchez — Maker · (503) 256-5200
NPI enumeratedFebruary 27, 2009
Last updated in NPPESFebruary 27, 2009
Mailing address11126 Ne Halsey St, Portland, OR 97220-2021

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