Medical school: ARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY
Graduated: 2003
Offers telehealth
NPI: 1164521654
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
9155 SW BARNES RD, SUITE 638
PORTLAND, OR 972256633
5032167000
Source: CMS National Downloadable File, September 2026.