Medical school: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated: 2003
NPI: 1790921005
Practice Locations (4)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10100 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
PORTLAND, OR 97230
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
2400 LANCASTER DR NE
SALEM, OR 973051221
8008132000
Source: CMS National Downloadable File, September 2026.