Graduated: 1999
NPI: 1104070663
Practice Locations (3)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10100 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
500 NE MULTNOMAH ST
PORTLAND, OR 972322023
Source: CMS National Downloadable File, September 2026.