Graduated: 2010
NPI: 1972822195
Practice Locations (4)
LEGACY CLINICS LLC
1130 NW 22ND AVE, SUITE 220
PORTLAND, OR 972102969
5034138988
LEGACY CLINICS LLC
19300 SW 65TH AVE, MERIDIAN PARK HOSP
PORTLAND, OR 970627706
5036921212
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 240
PORTLAND, OR 972132981
5032156480
PROVIDENCE HEALTH AND SERVICES OREGON
9205 SW BARNES RD
PORTLAND, OR 972256603
Source: CMS National Downloadable File, September 2026.