Graduated: 2018
Offers telehealth
NPI: 1154809903
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 972209439
5032154250
PROVIDENCE HEALTH AND SERVICES OREGON
4805 NE GLISAN ST
PORTLAND, OR 972132933
Source: CMS National Downloadable File, September 2026.