Healthcare Provider Details

I. General information

NPI: 1023512019
Provider Name (Legal Business Name): SEAN DANIEL MOTL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 09/11/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E 10TH AVE STE 260
EUGENE OR
97401-3362
US

IV. Provider business mailing address

401 E 10TH AVE STE 260
EUGENE OR
97401-3362
US

V. Phone/Fax

Practice location:
  • Phone: 541-600-4326
  • Fax: 844-408-0431
Mailing address:
  • Phone: 541-600-4326
  • Fax: 844-408-0431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD217941
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: