Medical school: VIRGINIA COMMONWEALTH UNIVERSITY, SCHOOL OF MEDICINE
Graduated: 1997
NPI: 1083682744
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 610
PORTLAND, OR 972132985
5034674761
PROVIDENCE HEALTH AND SERVICES - OREGON
9205 SW BARNES RD
PORTLAND, OR 972256603
5032162213
Source: CMS National Downloadable File, September 2026.