Graduated: 2020
NPI: 1962041996
Practice Locations (3)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
1230 7TH AVE
LONGVIEW, WA 986323166
8008132000
CLEAR CHOICE DERMATOLOGY
1815 HUDSON ST
LONGVIEW, WA 986322913
5413166575
Source: CMS National Downloadable File, September 2026.