Medical school: WASHINGTON STATE UNIVERSITY ELSON S FLOYD COLLEGE OF MEDICINE
Graduated: 2023
NPI: 1306541503
Practice Locations (3)
PO BOX, SUITE 3395
Portland, OR 972083395
PO BOX
PORTLAND, OR 97208
PO BOX, SUITE 3158
PORTLAND, OR 972083158
Source: CMS National Downloadable File, September 2026.