Graduated: 2004
NPI: 1285769539
Practice Locations (3)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
LAKE HEALTH DISTRICT
700 S J ST
LAKEVIEW, OR 976301623
5419472114
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
14406 NE 20TH AVE
VANCOUVER, WA 986861448
8008132000
Source: CMS National Downloadable File, September 2026.