Medical school: CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated: 2006
Also: FAMILY PRACTICE
NPI: 1144439266
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
914 S SCHEUBER RD
CENTRALIA, WA 985319027
3607362803
PROVIDENCE HEALTH AND SERVICES WASHINGTON
525 LILLY RD NE
OLYMPIA, WA 985065101
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
700 LILLY RD NE
OLYMPIA, WA 985065115
3609237000
Source: CMS National Downloadable File, September 2026.