Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 1995
NPI: 1083666127
Practice Locations (5)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
701 LEWISTON ST
COTTONWOOD, ID 835229750
2089623251
PROVIDENCE HEALTH AND SERVICES MT
500 W BROADWAY ST
MISSOULA, MT 598024096
4063295838
PROVIDENCE HEALTH AND SERVICES WASHINGTON
808 PORT DR
CLARKSTON, WA 994036009
5097476707
PROVIDENCE HEALTH AND SERVICES WASHINGTON
1200 E COLUMBIA AVE
COLVILLE, WA 991143354
5096843701
PROVIDENCE HEALTH AND SERVICES WASHINGTON
101 W 8TH AVE
SPOKANE, WA 992042307
Source: CMS National Downloadable File, September 2026.