Graduated: 2001
NPI: 1114176856
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
3600 N INTERSTATE AVE
PORTLAND, OR 972271106
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
3620 N INTERSTATE AVE
PORTLAND, OR 972271106
8008132000
Source: CMS National Downloadable File, September 2026.