Graduated: 2025
NPI: 1457042913
Practice Locations (5)
4105 W SAINT CHARLES AVE
PHOENIX, AZ 850414980
3425 E GRANT RD, SUITE 205
TUCSON, AZ 857162840
31405 18TH AVE S
Federal Way, WA 980035433
PO BOX
SEATTLE, WA 98124
11801 NE 65TH ST
Vancouver, WA 986625527
Source: CMS National Downloadable File, September 2026.