Graduated: 2013
Offers telehealth
NPI: 1053732677
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 972209439
5032154250
PROVIDENCE HEALTH AND SERVICES OREGON
4920 N INTERSTATE AVE
PORTLAND, OR 972173653
5032153300
Source: CMS National Downloadable File, September 2026.