Medical school: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1994
Offers telehealth
NPI: 1114952355
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
12442 SW SCHOLLS FERRY RD, SUITE 206
TIGARD, OR 972230804
5032169200
Source: CMS National Downloadable File, September 2026.