Graduated: 1996
NPI: 1578875696
Practice Locations (2)
MULTNOMAH COUNTY
600 NE 8TH ST
GRESHAM, OR 970307317
5039887468
MULTNOMAH COUNTY
12710 SE DIVISION, MID COUNTY HEALTH CENTER
PORTLAND, OR 972363134
5039883601
Source: CMS National Downloadable File, September 2026.