Medical school: UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduated: 1998
NPI: 1821002502
Practice Locations (2)
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
Source: CMS National Downloadable File, September 2026.