Graduated: 2013
NPI: 1043648330
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 454
PORTLAND, OR 972132984
5032156405
PROVIDENCE HEALTH AND SERVICES OREGON
12442 SW SCHOLLS FERRY RD, SUITE 100
TIGARD, OR 972230803
5032159900
Source: CMS National Downloadable File, September 2026.