Medical school: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2010
NPI: 1003133620
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
9205 SW BARNES RD, 3RD FLOOR MAT MT3401
PORTLAND, OR 972286603
5032156150
Source: CMS National Downloadable File, September 2026.