Graduated: 1985
NPI: 1366545394
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
2875 NE STUCKI AVE
HILLSBORO, OR 971245806
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
14406 NE 20TH AVE
VANCOUVER, WA 986861448
8008132000
Source: CMS National Downloadable File, September 2026.