Medical school: EDWARD VIA COL OF OSTEO MEDICINE-VIRGINIA CAMPUS
Graduated: 2020
NPI: 1255960191
Practice Locations (1)
LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER
1040 NW 22ND AVE, SUITE 520
PORTLAND, OR 972103097
5034137557
Source: CMS National Downloadable File, September 2026.