Graduated: 2023
NPI: 1891234399
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
9900 SE SUNNYSIDE RD
CLACKAMAS, OR 970159777
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
14406 NE 20TH AVE
VANCOUVER, WA 986861448
8008132000
Source: CMS National Downloadable File, September 2026.