Provider Demographics
NPI:1700307725
Name:WINETROUT, SETH ALEXANDER (RRT, AE-C)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:ALEXANDER
Last Name:WINETROUT
Suffix:
Gender:M
Credentials:RRT, AE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3135 ALAMEDA ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8644
Mailing Address - Country:US
Mailing Address - Phone:541-430-2033
Mailing Address - Fax:
Practice Address - Street 1:3135 ALAMEDA DR.
Practice Address - Street 2:UNIT 1
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-9750
Practice Address - Country:US
Practice Address - Phone:541-430-2033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRTP101701402279E1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279E1000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredEducational
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORRTP10170140OtherRRT LICENSE NUMBER