Graduated: 2021
NPI: 1922567247
Practice Locations (2)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
12607 SE MILL PLAIN BLVD
VANCOUVER, WA 986844098
8008132000
Source: CMS National Downloadable File, September 2026.