Graduated: 2012
NPI: 1265701452
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
NORTHSTAR ANESTHESIA III PA
12141 RICHMOND AVE
HOUSTON, TX 770822408
2815583444
Source: CMS National Downloadable File, September 2026.