Graduated: 2010
NPI: 1003128653
Practice Locations (2)
NEW PROACTIVE LLC
1307 NE 102ND AVE, SUITE T 1
PORTLAND, OR 972203980
9712700913
NEW PROACTIVE LLC
100 E 33RD ST, SUITE 204
VANCOUVER, WA 986632776
3608230138
Source: CMS National Downloadable File, September 2026.