Graduated: 2020
NPI: 1093314874
Practice Locations (2)
LEGACY MOUNT HOOD MEDICAL CENTER
24988 SE STARK ST, SUITE 220
GRESHAM, OR 970308324
5036741580
HOUSECALL PROVIDERS PC
5100 S MACADAM AVE, SUITE 200
PORTLAND, OR 972393827
9712025500
Source: CMS National Downloadable File, September 2026.