Noah James Delisle, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

10202246 Issued in OR

Practice address

5510 SE Rhone St
Portland, OR 97206-2966

Phone

(360) 524-2986

NPI assigned

Jan 10, 2023

Last updated

Jan 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1417661828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 SE RHONE ST APT SUITE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062966",
            "telephone_number": "360-524-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 SE RHONE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972062966",
            "telephone_number": "360-524-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELISLE",
        "first_name": "NOAH",
        "middle_name": "JAMES",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "10202246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "noah.delisle@providence.org",
            "affiliation": "N",
            "endpointDescription": "Secure email",
            "address_1": "5510 SE Rhone St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972062966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wendy Delgado
• Andrew Delgreco, LMT
• Delicious Life Wellness, LLC
• Adriana Michelle Deligio, PA-C
• Vincent Delisle-Todd
• Jennifer Dell
• Carol Ann Dell'Oliver, PH.D.
• Mark A Della Paolera, PHARMD, BCPS
• Elona Kassia Dellabough-Gormley
• Karen Ann Dellinger, MD

• Athletic Trainer in Portland, OR
• Providers in Portland, OR by specialty
• Athletic Trainer in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.