Graduated: 1999
NPI: 1083694244
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
3600 N INTERSTATE AVE
PORTLAND, OR 972271106
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
14406 NE 20TH AVE
VANCOUVER, WA 986861448
8008132000
Source: CMS National Downloadable File, September 2026.