NPIMap

Organization Active NPI

Advance Sports & Spine Therapy LLC

  • Physical Therapist
  • Wilsonville, OR
National Provider Identifier
1669405767
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ADVANCE SPORTS & SPINE THERAPY LLC
Practice address
25030 Parkway Ave
#101
Wilsonville, OR 97070
Phone
(503) 723-0347
Fax
(503) 655-9305
NPI assigned
Jul 9, 2006
Last updated
Aug 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Authorized official

Name
Mr. Noel M Tenoso, P.T.
Title
Owner
Phone
(503) 723-0347

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X OR
Physical Therapist 225100000X Primary

Addresses

Primary practice location

25030 Parkway Ave
#101
Wilsonville, OR 97070

Mailing address

1554 Garden St Ste 103
West Linn, OR 97068-3278
Phone (503) 723-0347

National Provider Directory

National Provider Directory

Locations

2001 NW 19th Ave
Ste 102
Portland, OR 97209
Phone (503) 360-0053

2034 NW 26th Ave
Portland, OR 97210
Phone (503) 384-2681

1554 Garden St
Ste 103
West Linn, OR 97068
Phone (503) 582-1073

22000 Willamette Dr
Ste 102
West Linn, OR 97068
Phone (503) 582-1073

25030 SW Parkway Ave
Ste 101
Wilsonville, OR 97070
Phone (503) 582-1073

8855 SW Holly Ln
Ste 123
Wilsonville, OR 97070
Phone (503) 582-1073

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1669405767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1554 GARDEN ST STE 103",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683278",
            "telephone_number": "503-723-0347",
            "fax_number": "503-655-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25030 PARKWAY AVE",
            "address_2": "#101",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "97070",
            "telephone_number": "503-723-0347",
            "fax_number": "503-655-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE SPORTS & SPINE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "TENOSO",
        "authorized_official_first_name": "NOEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-723-0347",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilsonville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.