Medical school: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduated: 1993
NPI: 1093731093
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES OREGON
1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 972209439
5032154250
PROVIDENCE HEALTH AND SERVICES OREGON
417 SW 117TH AVE
PORTLAND, OR 972255924
PROVIDENCE HEALTH AND SERVICES OREGON
9205 SW BARNES RD
PORTLAND, OR 972256603
Source: CMS National Downloadable File, September 2026.