Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated: 1997
NPI: 1639285034
Practice Locations (2)
2320 130TH AVE NE
BELLEVUE, WA 980051718
8888329003
2320 130TH AVE NE, SUITE 220
BELLEVUE, WA 980051718
8888329003
Source: CMS National Downloadable File, September 2026.