Provider Demographics
NPI:1487636049
Name:HUTTON, SETH RAYMOND (DC)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:RAYMOND
Last Name:HUTTON
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 1:703 BROADWAY
Mailing Address - Street 2:SUITE 650
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660
Mailing Address - Country:US
Mailing Address - Phone:360-690-0081
Mailing Address - Fax:360-690-0083
Practice Address - Street 1:703 BROADWAY
Practice Address - Street 2:SUITE 650
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660
Practice Address - Country:US
Practice Address - Phone:360-690-0081
Practice Address - Fax:360-690-0083
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034107111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
U89616Medicare UPIN
AB28144Medicare PIN