Graduated: 1996
NPI: 1437197852
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
5940 ULALI DR NE
KEIZER, OR 973031500
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
2400 LANCASTER DR NE
SALEM, OR 973051221
8008132000
Source: CMS National Downloadable File, September 2026.