Medical school: AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated: 1984
NPI: 1124082458
Practice Locations (1)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
9800 SE SUNNYSIDE RD
CLACKAMAS, OR 970159750
8008132000
Source: CMS National Downloadable File, September 2026.