Medical school: UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated: 2000
NPI: 1720114002
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
1230 7TH AVE
LONGVIEW, WA 986323166
8008132000
Source: CMS National Downloadable File, September 2026.