Medical school: OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated: 1994
NPI: 1902905540
Practice Locations (4)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10100 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
9900 SE SUNNYSIDE RD
CLACKAMAS, OR 970159777
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
7101 NE 137TH AVE
VANCOUVER, WA 986824933
8008132000
Source: CMS National Downloadable File, September 2026.