Provider Demographics
NPI:1720287279
Name:SEATON, KRISTEN L (LMT)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:L
Last Name:SEATON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5690 W PLUMBAGO AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNS
Mailing Address - State:UT
Mailing Address - Zip Code:84118-7651
Mailing Address - Country:US
Mailing Address - Phone:503-332-5448
Mailing Address - Fax:
Practice Address - Street 1:5690 W PLUMBAGO AVE
Practice Address - Street 2:
Practice Address - City:KEARNS
Practice Address - State:UT
Practice Address - Zip Code:84118-7651
Practice Address - Country:US
Practice Address - Phone:503-332-5448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-15
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12576225700000X
UT14082198-4701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist