Graduated: 2016
NPI: 1306383930
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
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
1700 NE 102ND AVE
PORTLAND, OR 972203804
8008132000
Source: CMS National Downloadable File, September 2026.