Graduated: 2022
NPI: 1740965250
Practice Locations (4)
619 NW 6TH AVE FL, SUITE 5
Portland, OR 972093991
619 NW 6TH AVE, FL 5
PORTLAND, OR 972093991
636 NE STAFFORD ST
PORTLAND, OR 972113574
25195 SW PKWY AVE, SUITE 200
WILSONVILLE, OR 970709689
Source: CMS National Downloadable File, September 2026.