Graduated: 2021
NPI: 1528689031
Practice Locations (3)
1110 SE ALDER ST, SUITE 301
PORTLAND, OR 972142400
9713002306
2530 NE SARATOGA ST
PORTLAND, OR 972115958
PO BOX, SUITE 9
Tillamook, OR 971410009
Source: CMS National Downloadable File, September 2026.