Individual provider Active NPI

Sequoia Lavoy, PT

  • Physical Therapist
  • Salem, OR
National Provider Identifier
1053062968
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
64356 Issued in OR
Practice address
2521 Boone Rd SE # 100
Salem, OR 97306-9391
Phone
(503) 585-5131
NPI assigned
Jan 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 64356 OR Primary

Addresses

Primary practice location

2521 Boone Rd SE # 100
Salem, OR 97306-9391

Mailing address

685 36TH Ave NE
Salem, OR 97301-4741
Phone (503) 585-5131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64356ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Rehabilitation Associates, Inc. Physical Therapist CurrentSince Jan 3, 2023 Accepting new patients
PT Northwest LLC Past Accepting new patients
Physical Therapy Northwest Limited Partnership Physical Therapist PastSince Jan 21, 2022 Accepting new patients

Locations

4025 Cherry Ave NE
Keizer, OR 97303
Phone (503) 390-9009

3270 Liberty Rd S
Salem, OR 97302
Phone (503) 371-0779

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1053062968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 36TH AVE NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014741",
            "telephone_number": "503-585-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 BOONE RD SE # 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973069391",
            "telephone_number": "503-585-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVOY",
        "first_name": "SEQUOIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "64356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.