Malinda Catherine Sevilla, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

62898 Issued in OR

Practice address

445 Harlow Rd Ste 120
Springfield, OR 97477-1341

Phone

(541) 736-8870

Fax

(541) 736-8860

NPI assigned

Aug 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Malinda Cavage Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Therapeutic Associates Inc

  dba TAI - North Creek

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1043790314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "503-443-6156",
            "fax_number": "503-639-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 HARLOW RD STE 120",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771341",
            "telephone_number": "541-736-8870",
            "fax_number": "541-736-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVILLA",
        "first_name": "MALINDA",
        "middle_name": "CATHERINE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500751157",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALINDA",
            "last_name": "CAVAGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heidi Marie Semple, NP
• Zakhar Serkin
• Seth Holland, DMD, LLC
• Damon W Sevart, PA-C
• Tawnya Jean Severe, MSW, CSWA, QMHP-C
• Kristin Seybold
• Angela M Seyler, PHARM D
• Bayley Brooke Seymour, PA-C
• Joyce Elsie Shain, MA, OTR/L
• Christopher Dean Shakespear, DMD

• Physical Therapist in Springfield, OR
• Providers in Springfield, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.