Graduated: 2023
NPI: 1104600329
Practice Locations (4)
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
3500 N INTERSTATE AVE
PORTLAND, OR 972271196
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
3550 N INTERSTATE AVE
PORTLAND, OR 972271196
8008132000
Source: CMS National Downloadable File, September 2026.