Medical school: JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Graduated: 1996
NPI: 1417949926
Practice Locations (6)
LEGACY CLINICS LLC
1015 NW 22ND AVE
PORTLAND, OR 972103025
5034137711
LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER
1015 NW 22ND AVE
PORTLAND, OR 972103025
5034137711
LEGACY CLINICS LLC
1015 NW22ND AVE, SUITE 34
PORTLAND, OR 972103025
5034136376
LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER
1040 NW 22ND AVE
PORTLAND, OR 972103097
LEGACY CLINICS LLC
1130 NW 22ND AVE, SUITE 220
PORTLAND, OR 972102969
5034138988
LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER
1200 NW 23RD AVE
PORTLAND, OR 972102906
5034137074
Source: CMS National Downloadable File, September 2026.