KELSEY MARIE LAVAUTE (NPI# 1164037065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164037065 |
| Entity Type | Individual |
| Full Name | KELSEY MARIE LAVAUTE |
| Practice Address |
11782 Sw Barnes Rd Ste 300 Portland OR 97225-5933 |
| Practice Telephone | 5032145200 |
| Practice Fax Number | 5039066613 |
| Mailing Telephone | 5032145200 |
| Mailing Fax Number | 5039066613 |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
63665 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500784275 | 05 | |
| OR | PT LICENSE | 63665 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 14795 Sw Murray Scholls Dr Ste 109, Beaverton, OR 970079230 | 5039064301 | 5039066613 |
| Street Address |
11782 SW BARNES RD STE 300 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-5933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639284714 | Payton Alan Haynes | Specialist/Technologist | 11782 Sw Barnes Rd Ste 300, The Orthopedic & Fracture Clinic, Portland, OR 97225-5933 | 2006-08-20 |
| 1649835273 | Kevin Quangkien Mai | Occupational Therapist | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2019-05-08 |
| 1871050153 | Orthopedic & Fracture Clinic PC | Orthopaedic Surgery | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2019-02-22 |
| 1942712047 | Heath L Meir | Physician Assistant | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2017-10-30 |
| 1336650159 | Kara M Beasley | Physician Assistant | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2017-10-19 |
| 1902242506 | Jeana Lyn Summers | Neuromusculoskeletal Medicine & OMM | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2013-05-22 |
| 1447593967 | Hannah Fae Aultman | Orthopaedic Surgery | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2013-04-03 |
| 1720303308 | Richard Douglas Southgate | Orthopaedic Surgery | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2010-04-07 |
| 1891020673 | Jared Rickard Jones | Physical Therapist | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2009-10-12 |
| 1780812552 | Ashley H. Carpenter | Physical Therapist | 11782 Sw Barnes Rd Ste 300, Portland, OR 97225-5933 | 2009-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170411 | Mind Body Therapy | Physical Therapist | 11959 Sw Garden Pl, Portland, OR 97223-8249 | 2020-09-24 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1093204562 | Jessica Hund | Physical Therapist | 9385 Sw Greenburg Rd Ste 100, Portland, OR 97223-3200 | 2018-05-09 |
| 1659899151 | Mariel Hammond | Physical Therapist | 7522 N Lombard St, Portland, OR 97203-3235 | 2017-09-05 |
| 1437516515 | Caleb Joseph Wright | Physical Therapist | 8628 Se 17th Ave, Portland, OR 97202-0000 | 2016-01-20 |
| 1881840692 | Jennifer Lynne Davis | Physical Therapist | 7718 Se 13th Ave, Portland, OR 97202-6348 | 2008-08-12 |
| 1093977316 | Julie A Jacobson | Physical Therapist | 10428 Ne Pacific St, Portland, OR 97220-4028 | 2008-06-27 |
| 1427225606 | Kofoed Enteprises PC | Physical Therapist | 1020 Sw Taylor Street Suite 665, Portland, OR 97205-2529 | 2008-05-15 |
| 1770619595 | Shawn Patrick Cooney | Physical Therapist | 3108 Ne 181st Ave, Portland, OR 97230-6926 | 2007-02-26 |
| 1811039035 | Kevin A Schmidt | Physical Therapist | 2622 Se 25th Ave, Suite B, Portland, OR 97202-1217 | 2007-02-13 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.