Graduated: 2006
NPI: 1700020328
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
9800 SE SUNNYSIDE RD
CLACKAMAS, OR 970159750
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
14406 NE 20TH AVE
VANCOUVER, WA 986861448
8008132000
Source: CMS National Downloadable File, September 2026.