Provider Demographics
NPI:1598096760
Name:PERRINE, SETH PETER (LMT)
Entity Type:Individual
Prefix:MR
First Name:SETH
Middle Name:PETER
Last Name:PERRINE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4515 SW CORBETT AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4289
Mailing Address - Country:US
Mailing Address - Phone:503-224-5464
Mailing Address - Fax:503-222-9474
Practice Address - Street 1:4515 SW CORBETT AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4289
Practice Address - Country:US
Practice Address - Phone:503-224-5464
Practice Address - Fax:503-222-9474
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor