Provider Demographics
NPI:1841334141
Name:TENOSO, NOEL MARCEL (PT)
Entity type:Individual
Prefix:MR
First Name:NOEL
Middle Name:MARCEL
Last Name:TENOSO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1905 SE 192ND AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7415
Mailing Address - Country:US
Mailing Address - Phone:360-210-5440
Mailing Address - Fax:360-210-7731
Practice Address - Street 1:1554 GARDEN ST
Practice Address - Street 2:SUITE #103
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-3278
Practice Address - Country:US
Practice Address - Phone:971-353-5440
Practice Address - Fax:503-655-9305
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1769225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR112515Medicare PIN
R112514Medicare PIN