Medical school: CHICAGO COLLEGE OF MEDICINE AND SURGERY
Graduated: 1987
NPI: 1770544900
Practice Locations (2)
LEGACY CLINICS LLC
1130 NW 22ND AVE, SUITE 220
PORTLAND, OR 972102969
5034138988
LEGACY CLINICS LLC
19300 SW 65TH AVE, MERIDIAN PARK HOSP
PORTLAND, OR 970627706
5036921212
Source: CMS National Downloadable File, September 2026.