Healthcare Provider Details

I. General information

NPI: 1467079673
Provider Name (Legal Business Name): SARAH SEVCECH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAVALE SEVCECH

II. Dates (important events)

Enumeration Date: 07/03/2020
Last Update Date: 07/03/2020
Certification Date: 07/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12901 SE 97TH AVE STE 340
CLACKAMAS OR
97015-7903
US

IV. Provider business mailing address

2755 SE 98TH AVE
PORTLAND OR
97266-1303
US

V. Phone/Fax

Practice location:
  • Phone: 503-655-8045
  • Fax:
Mailing address:
  • Phone: 571-217-3327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: