Unless otherwise indicated, this information has been self-reported and has not been verified by the Board of Medicine.
Primary Practice Address
Last Updated 4/29/2024
None Reported
Additional Practice Address
Last Updated 4/29/2024
1130 NW 22nd Ave #150
Portland, OR 97210
Phone: 9712629600
Location Details
- Practitioner spends 0% of time at this location.
Years in Active Clinical Practice
Last Updated 4/29/2024
Years in Active Clinical Practice Inside US/Canada: 6
Medicaid
Last Updated 4/29/2024
Does Not Participate in the Virginia Medicaid program Is not accepting new Virginia Medicaid patients
Virginia
Hospital Affiliations
Last Updated 4/29/2024
None Reported
Hospital Affiliations in States Other Than Virginia
Last Updated 4/29/2024
(Potland,OR) OHSU
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