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Doctors / OR
UNDEFINED PHYSICIAN TYPE (SPECIFY)
Graduated: 1991
Also: PEDIATRIC MEDICINE
NPI: 1568438828
1075 NW NORTHRUP ST, SUITE 1015
Portland, OR 972092772
PO BOX, SUITE 5299
TACOMA, WA 98415
Source: CMS National Downloadable File, September 2026.