Medical school: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Graduated: 1996
NPI: 1356674402
Practice Locations (3)
PO BOX, SUITE 40155
Bellevue, WA 980154155
1400 112TH AVE SE, SUITE 204
BELLEVUE, WA 980046901
4254447733
PO BOX, SUITE 40155
BELLEVUE, WA 98015
Source: CMS National Downloadable File, September 2026.