Provider Demographics
NPI:1952712358
Name:SEATON, TIMOTHY L (LAC, LMT, CPT)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:L
Last Name:SEATON
Suffix:
Gender:M
Credentials:LAC, LMT, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 NW EVERETT ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2655
Mailing Address - Country:US
Mailing Address - Phone:971-433-5334
Mailing Address - Fax:971-200-8669
Practice Address - Street 1:1355 NW EVERETT ST STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2655
Practice Address - Country:US
Practice Address - Phone:971-433-5334
Practice Address - Fax:971-200-8669
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X, 247ZC0005X, 246RP1900X
TXMT132983225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician