Graduated: 2022
NPI: 1245939768
Practice Locations (3)
9620 NE TANASBOURNE DR, SUITE 300
HILLSBORO, OR 971247844
909 SE 12TH AVE, APT 328
PORTLAND, OR 972142581
9713653642
4578 NORFOLK ST
West Linn, OR 970683862
Source: CMS National Downloadable File, September 2026.