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 1:1155 SW MORRISON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2254
Mailing Address - Country:US
Mailing Address - Phone:800-803-8263
Mailing Address - Fax:971-777-7270
Practice Address - Street 1:1155 SW MORRISON ST STE 200
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2254
Practice Address - Country:US
Practice Address - Phone:800-803-8263
Practice Address - Fax:971-777-7270
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT132983225700000X
171100000X, 246RP1900X, 246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171100000XOther Service ProvidersAcupuncturist
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy