Medical school: TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Graduated: 1997
NPI: 1275615585
Practice Locations (3)
31405 18TH AVE S
Federal Way, WA 980035433
PO BOX
SEATTLE, WA 98124
PO BOX, SUITE 34703
SEATTLE, WA 981241703
Source: CMS National Downloadable File, September 2026.