Graduated: 2006
NPI: 1720487994
Practice Locations (4)
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
1221 MERCANTILE LN
LARGO, MD 207745374
3016185700
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
12201 PLUM ORCHARD DR
SILVER SPRING, MD 209047803
3015721000
SOUTH SOUND INPATIENT PHYSICIANS PLLC
407 14TH AVE SE
PUYALLUP, WA 983723770
2536974000
SOUTH SOUND INPATIENT PHYSICIANS PLLC
400 NE MOTHER JOSEPH PL
VANCOUVER, WA 986643200
3605143727
Source: CMS National Downloadable File, September 2026.