Graduated: 2016
NPI: 1104369099
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
870 S FRONT ST, SUITE 200
CENTRAL POINT, OR 975022779
5416643346
PROVIDENCE HEALTH AND SERVICES OREGON
940 ROYAL AVE
MEDFORD, OR 975046194
Source: CMS National Downloadable File, September 2026.