Graduated: 2003
NPI: 1194740159
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
11511 NE 10TH ST
BELLEVUE, WA 980048578
4255023000
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
200 15TH AVE E
SEATTLE, WA 981125260
2063263000
Source: CMS National Downloadable File, September 2026.