Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1982
NPI: 1821015678
Practice Locations (1)
COLUMBIA LUTHERAN CHARITIES
2111 EXCHANGE ST
ASTORIA, OR 971033329
5033254321
Source: CMS National Downloadable File, September 2026.