Medical school: ST. LOUIS COLLEGE OF PHYSICIANS AND SURGEONS
Graduated: 1995
Offers telehealth
NPI: 1972577740
Practice Locations (1)
LEGACY CLINICS LLC
1130 NW 22ND AVE, SUITE 220
PORTLAND, OR 972102969
5034138988
Source: CMS National Downloadable File, September 2026.