Medical school: UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduated: 1996
Offers telehealth
NPI: 1033273784
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
15640 NW LAIDLAW RD, SUITE 102
PORTLAND, OR 972293828
5037640100
Source: CMS National Downloadable File, September 2026.