Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 1995
NPI: 1427141548
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
14406 NE 20TH AVE
VANCOUVER, WA 986861448
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
7101 NE 137TH AVE
VANCOUVER, WA 986824933
8008132000
Source: CMS National Downloadable File, September 2026.