Medical school: PACIFIC NW UN OF HS, COL OF OSTEOPATHIC MEDICINE
Graduated: 2012
NPI: 1053666081
Practice Locations (1)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
1230 7TH AVE
LONGVIEW, WA 986323166
8008132000
Source: CMS National Downloadable File, September 2026.