Medical school: WESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF DENTAL MED
Graduated: 2011
NPI: 1730474974
Practice Locations (2)
LEGACY CLINICS LLC
24800 SE STARK ST
GRESHAM, OR 970303378
5034138988
LEGACY CLINICS LLC
1130 NW 22ND AVE, SUITE 220
PORTLAND, OR 972102969
5034138988
Source: CMS National Downloadable File, September 2026.