Medical school: UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
Graduated: 1990
NPI: 1508972159
Practice Locations (1)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
12607 SE MILL PLAIN BLVD
VANCOUVER, WA 986844098
8008132000
Source: CMS National Downloadable File, September 2026.