Medical school: UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated: 1989
NPI: 1932102365
Practice Locations (1)
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
11511 NE 10TH ST
BELLEVUE, WA 980048578
4255023000
Source: CMS National Downloadable File, September 2026.