Graduated: 1996
NPI: 1831285592
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
5125 SKYLINE RD S
SALEM, OR 973069427
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
14406 NE 20TH AVE
VANCOUVER, WA 986861448
8008132000
Source: CMS National Downloadable File, September 2026.