Individual provider Active NPI

Michele Lynn Sequeira, MD

  • Family Medicine Physician
  • Vancouver, WA
National Provider Identifier
1013937473
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00041130 Issued in WA
Practice address
12607 SE Mill Plain Blvd
Vancouver, WA 98684-6055
Phone
(360) 891-6208
Fax
(360) 418-6006
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD22410 OR
Family Medicine Physician 207Q00000X DR.0067303 CO
Family Medicine Physician 207Q00000X MD00041130 WA Primary

Addresses

Primary practice location

12607 SE Mill Plain Blvd
Vancouver, WA 98684-6055

Mailing address

12607 SE Mill Plain Blvd
Vancouver, WA 98684-6055

Other names 1

  • Michele Carlin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR, TX, NM, CO5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20051025000070 WA Practitioner - Family Practice 8729005251 Reassigns benefits to 2 organizations
I20051227000580 OR Practitioner - Family Practice 8729005251 Reassigns benefits to 1 organization
I20181228000315 TX Practitioner - Family Practice 8729005251 Reassigns benefits to 1 organization
I20190103000716 NM Practitioner - Family Practice 8729005251 Reassigns benefits to 1 organization
I20220429001274 CO Practitioner - Family Practice 8729005251 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0067303COMDFamily Medicine Physician
MD22410ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 20, 2008 Accepting new patients
Pueblo Pintado Clinic CurrentSince Nov 13, 2018 Accepting new patients
Colorado Permanente Medical Group, P.C. CurrentSince Jan 12, 2022 Accepting new patients
DHHS PHS Naihs Crownpoint Hospital Current Accepting new patients
Thoreau Clinic CurrentSince Nov 13, 2018 Accepting new patients
Presbyterian Healthcare Services Family Medicine CurrentSince Jan 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 1, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Jan 6, 2020 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 1, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 20, 2008 Accepting new patients
Presbyterian Healthcare Services CurrentSince Jan 1, 2019 Accepting new patients
West Valley Hospital Pharmacy Past Accepting new patients
Salem Health West Valley PastSince Mar 3, 2011 Accepting new patients
Salem Radiology Consultants PC Past Accepting new patients

Locations

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

10350 E Dakota Ave
Ofc
Denver, CO 80247
Phone (303) 344-7771

5901 Harper Dr NE
Albuquerque, NM 87109
Phone (505) 823-8233

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

720 W Main St
Ste 115
Battle Ground, WA 98604
Phone (360) 666-3900

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

275 Bronson Way NE
Renton, WA 98056
Phone (425) 235-2800

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

12607 SE Mill Plain Blvd
Vancouver, WA 98684
Phone (360) 418-6001

Interoperability endpoints

  • Direct secure messaging: msequeira2915330@ghc.direct-ci.net

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1013937473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12607 SE MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12607 SE MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846055",
            "telephone_number": "360-891-6208",
            "fax_number": "360-418-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEQUEIRA",
        "first_name": "MICHELE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD22410",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0067303",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00041130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "CARLIN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.