Graduated: 2022
NPI: 1144801895
Practice Locations (4)
2354 W POLK ST, UNIT 504
CHICAGO, IL 606125801
4100 INTERNATIONAL PLZ, SUITE 800
Fort Worth, TX 761094839
325 9TH AVE
SEATTLE, WA 981042499
PO BOX, SUITE 50095
SEATTLE, WA 98145
Source: CMS National Downloadable File, September 2026.