Provider Demographics
NPI:1720396344
Name:SEALE, MICHAEL M (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:M
Last Name:SEALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2757 22ND ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1553
Mailing Address - Country:US
Mailing Address - Phone:503-400-1972
Mailing Address - Fax:
Practice Address - Street 1:24499 SW GRAHAMS FERRY RD
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-7523
Practice Address - Country:US
Practice Address - Phone:503-570-6710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD173356207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine