Graduated: 2013
NPI: 1114345022
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
1200 E COLUMBIA AVE
COLVILLE, WA 991143354
5096843701
PROVIDENCE HEALTH AND SERVICES WASHINGTON
1212 N PINES RD
SPOKANE VALLEY, WA 992064939
5098938140
Source: CMS National Downloadable File, September 2026.