Graduated: 1995
NPI: 1992014385
Practice Locations (3)
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10100 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
2850 NW NICOLAI ST
PORTLAND, OR 972102018
8008132000
Source: CMS National Downloadable File, September 2026.