Medical school: JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Graduated: 1996
NPI: 1851387484
Practice Locations (3)
LEGACY EMANUEL HOSPITAL AND HEALTH CENTER
2800 N VANCOUVER AVE, SUITE 230
PORTLAND, OR 972271668
5034134340
LEGACY CLINICS LLC
2801 N GANTENBEIN AVE
PORTLAND, OR 972271623
5034132200
LEGACY EMANUEL HOSPITAL AND HEALTH CENTER
2801 N GANTENBEIN AVE
PORTLAND, OR 972271623
5034132042
Source: CMS National Downloadable File, September 2026.