Graduated: 1991
NPI: 1992751507
Practice Locations (3)
PORTLAND CLINIC
15950 SW MILLIKAN WAY
BEAVERTON, OR 970035170
5036460161
PORTLAND CLINIC
800 SW 13TH AVE
PORTLAND, OR 972051902
50322101612110
PORTLAND CLINIC
9250 SW HALL BLVD
TIGARD, OR 972236721
5032930161
Source: CMS National Downloadable File, September 2026.