Medical school: MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduated: 2004
NPI: 1407075534
Practice Locations (2)
LEGACY CLINICS LLC
1130 NW 22ND AVE, SUITE 220
PORTLAND, OR 972102969
5034138988
LEGACY CLINICS LLC
19300 SW 65TH AVE, MERIDIAN PARK HOSP
PORTLAND, OR 970627706
5036921212
Source: CMS National Downloadable File, September 2026.