Graduated: 2022
NPI: 1679203699
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
5125 SKYLINE RD S
SALEM, OR 973069427
8008132000
MULTICARE HEALTH SYSTEM
6704 TACOMA MALL BLVD, SUITE 100
TACOMA, WA 984099001
2534754870
Source: CMS National Downloadable File, September 2026.