Graduated: 2002
NPI: 1134340904
Practice Locations (3)
LEGACY CLINICS LLC
1130 NW 22ND AVE, SUITE 220
PORTLAND, OR 972102969
5034138988
LEGACY CLINICS LLC
19300 SW 65TH AVE, MERIDIAN PARK HOSP
PORTLAND, OR 970627706
5036921212
LEGACY CLINICS LLC
19250 SW 65TH AVE, SUITE 265
TUALATIN, OR 970627747
5034136862
Source: CMS National Downloadable File, September 2026.