Graduated: 2022
NPI: 1689266785
Practice Locations (3)
MULTNOMAH COUNTY
600 NE 8TH ST
GRESHAM, OR 970307317
5039887468
MULTNOMAH COUNTY
12710 SE DIVISION
PORTLAND, OR 972363134
5039883601
MULTNOMAH COUNTY
12710 SE DIVISION, MID COUNTY HEALTH CENTER
PORTLAND, OR 972363134
5039883601
Source: CMS National Downloadable File, September 2026.