Provider Demographics
NPI:1215132303
Name:SEATON, KENNETH JAY SR (MS, LMHC, CSAT)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:JAY
Last Name:SEATON
Suffix:SR
Gender:M
Credentials:MS, LMHC, CSAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14155 GLENWOOD RD SW
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-7769
Mailing Address - Country:US
Mailing Address - Phone:360-876-2765
Mailing Address - Fax:
Practice Address - Street 1:3208 50TH STREET CT NW
Practice Address - Street 2:BLDG C, SUITE 100
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8590
Practice Address - Country:US
Practice Address - Phone:360-621-9286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004211101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health