Graduated: 2004
NPI: 1053668335
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES- WASHINGTON
12800 BOTHELL EVERETT HWY
EVERETT, WA 982086644
PROVIDENCE HEALTH AND SERVICES- WASHINGTON
4112 HARBOUR POINTE BLVD SW, SUITE 100
MUKILTEO, WA 982755457
4253476330
Source: CMS National Downloadable File, September 2026.