Provider Demographics
NPI:1528259884
Name:MERRITT, SETH ALLEN (FNP, RN)
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:ALLEN
Last Name:MERRITT
Suffix:
Gender:M
Credentials:FNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 SE MILWAUKIE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-5344
Mailing Address - Country:US
Mailing Address - Phone:971-258-1120
Mailing Address - Fax:866-309-2838
Practice Address - Street 1:6035 SE MILWAUKIE AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-5344
Practice Address - Country:US
Practice Address - Phone:971-258-1120
Practice Address - Fax:866-309-2838
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200850079NP363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily