Graduated: 2023
NPI: 1497472906
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
19500 SE STARK ST
PORTLAND, OR 972335757
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
14406 NE 20TH AVE
VANCOUVER, WA 986861448
8008132000
Source: CMS National Downloadable File, September 2026.