Medical school: OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 2011
NPI: 1124312004
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
615 LILLY RD NE, SUITE 200
OLYMPIA, WA 985065137
3604138413
Source: CMS National Downloadable File, September 2026.