Graduated: 2017
NPI: 1861988503
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
14406 NE 20TH AVE
VANCOUVER, WA 986861448
8008132000
Source: CMS National Downloadable File, September 2026.