Graduated: 2022
NPI: 1083248504
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES OREGON
1111 CRATER LAKE AVE
MEDFORD, OR 975046241
5417326274
PROVIDENCE HEALTH AND SERVICES OREGON
1500 DIVISION ST, RM 1005
OREGON CITY, OR 970451527
5032152669
PROVIDENCE HEALTH AND SERVICES OREGON
9205 SW BARNES RD, SUITE MT2159
PORTLAND, OR 972256603
5032152669
Source: CMS National Downloadable File, September 2026.