Graduated: 1985
NPI: 1891750329
Practice Locations (5)
FANNO CREEK CLINIC LLC
2400 SW VERMONT ST
PORTLAND, OR 972191940
5034520915
PROVIDENCE HEALTH AND SERVICES - OREGON
9205 SW BARNES RD
PORTLAND, OR 972256603
5032162213
PROVIDENCE HEALTH AND SERVICES - OREGON
9205 SW BARNES RD, SUITE 20
PORTLAND, OR 972256603
5032162229
LEGACY MERIDIAN PARK HOSPITAL
19300 SW 65TH AVE
TUALATIN, OR 970627706
5034134330
6787 SW WAMPANOAG DR
TUALATIN, OR 970629223
5033446462
Source: CMS National Downloadable File, September 2026.