Graduated: 1999
NPI: 1003811712
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
1200 E COLUMBIA AVE
COLVILLE, WA 991143354
5096843701
PROVIDENCE HEALTH AND SERVICES WASHINGTON
105 W 8TH AVE
SPOKANE, WA 992042318
Source: CMS National Downloadable File, September 2026.