Graduated: 2006
NPI: 1801096912
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
12100 SE STEVENS CT, SUITE 106
PORTLAND, OR 970864707
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
12607 SE MILL PLAIN BLVD
VANCOUVER, WA 986844098
8008132000
Source: CMS National Downloadable File, September 2026.