Provider Demographics
NPI:1083686836
Name:SEATER, FRED (DC)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:
Last Name:SEATER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16280 S APPERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1102
Mailing Address - Country:US
Mailing Address - Phone:503-656-3188
Mailing Address - Fax:
Practice Address - Street 1:4141 SE HARRISON ST
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-5859
Practice Address - Country:US
Practice Address - Phone:503-653-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3595111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORV08804Medicare UPIN
OR134380Medicare PIN