Medical school: UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Graduated: 2004
NPI: 1265582233
Practice Locations (3)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10100 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
LEGACY CLINICS LLC
19300 SW 65TH AVE, MERIDIAN PARK HOSP
PORTLAND, OR 970627706
5036921212
Source: CMS National Downloadable File, September 2026.