Graduated: 2019
NPI: 1558068791
Practice Locations (2)
COWLITZ INDIAN TRIBE
1044 11TH AVE
LONGVIEW, WA 986322506
3605753314
THE VANCOUVER CLINIC INC PS
700 NE 87TH AVE
VANCOUVER, WA 986641913
3608822778
Source: CMS National Downloadable File, September 2026.