Graduated: 2011
NPI: 1164719324
Practice Locations (3)
3050 SE DIVISION ST, SUITE 260
PORTLAND, OR 972021994
5033001450
4022 SE 51ST AVE
PORTLAND, OR 972063076
PO BOX, SUITE 9
Tillamook, OR 971410009
Source: CMS National Downloadable File, September 2026.