Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 1995
NPI: 1982667630
Practice Locations (6)
LEGACY CLINICS LLC
24800 SE STARK ST
GRESHAM, OR 970303378
5034138988
LEGACY CLINICS LLC
1130 NW 22ND AVE, SUITE 220
PORTLAND, OR 972102969
5034138988
LEGACY CLINICS LLC
2801 N GANTENBEIN AVE
PORTLAND, OR 972271623
5034131122
LEGACY CLINICS LLC
501 N GRAHAM ST, SUITE 415
PORTLAND, OR 972272006
5034133580
LEGACY SALMON CREEK HOSPITAL
2101 NE 139TH ST, SUITE 260
VANCOUVER, WA 986862311
3604872870
LEGACY SALMON CREEK HOSPITAL
2211 NE 139TH ST
VANCOUVER, WA 986862742
3604871000
Source: CMS National Downloadable File, September 2026.