Medical school: SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1997
NPI: 1538247259
Practice Locations (3)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10100 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
1230 7TH AVE
LONGVIEW, WA 986323166
8008132000
Source: CMS National Downloadable File, September 2026.