Graduated: 2012
NPI: 1437402237
Practice Locations (2)
GROUP HEALTH PLAN INC
205 WABASHA AVE S
SAINT PAUL, MN 551071805
6512938100
LEGACY CLINICS LLC
2800 N VANCOUVER AVE
PORTLAND, OR 972271630
5034134992
Source: CMS National Downloadable File, September 2026.