Graduated: 1979
NPI: 1063400752
Practice Locations (6)
LEGACY CLINICS LLC
24800 SE STARK ST
GRESHAM, OR 970303378
5034138988
LEGACY CLINICS LLC
1015 NW 22ND AVE
PORTLAND, OR 972103025
5034137711
LEGACY CLINICS LLC
1015 NW22ND AVE, SUITE 34
PORTLAND, OR 972103025
5034136376
LEGACY CLINICS LLC
1130 NW 22ND AVE, SUITE 220
PORTLAND, OR 972102969
5034138988
LEGACY SALMON CREEK HOSPITAL
2121 NE 139TH ST
VANCOUVER, WA 986862316
LEGACY SALMON CREEK HOSPITAL
2211 NE 139TH ST
VANCOUVER, WA 986862742
3604871000
Source: CMS National Downloadable File, September 2026.