Graduated: 2009
NPI: 1740506237
Practice Locations (2)
LEGACY CLINICS LLC
24850 SE STARK ST, SUITE 200
GRESHAM, OR 970308320
5034919444
LEGACY CLINICS LLC
1130 NW 22ND AVE, SUITE 220
PORTLAND, OR 972102969
5034138988
Source: CMS National Downloadable File, September 2026.