Graduated: 2016
NPI: 1730693615
Practice Locations (4)
PO BOX, SUITE 2350
ROCKLIN, CA 95677
3905 SW 117TH AVE A
BEAVERTON, OR 970058905
1622 SE CLATSOP ST
PORTLAND, OR 972027227
1815 SW MARLOW AVE, SUITE 110
PORTLAND, OR 972255186
Source: CMS National Downloadable File, September 2026.