Graduated: 2023
NPI: 1235908567
Practice Locations (4)
5601 CAPTAINS LN
Wilmington, NC 284093619
217 DIVISION AVE
EUGENE, OR 974045423
PO BOX, SUITE 1602
Lake Oswego, OR 970350562
1115 SE 164TH AVE, DEPT 358
VANCOUVER, WA 986838004
Source: CMS National Downloadable File, September 2026.