Individual
NOAH JAMES DELISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
5510 SE RHONE ST, PORTLAND, OR 97206-2966
(360) 524-2986
Mailing address
5510 SE RHONE ST APT SUITE, PORTLAND, OR 97206-2966
(360) 524-2986
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
10202246
OR
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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