Graduated: 1993
NPI: 1174711634
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
EVERETT, WA 98201
PROVIDENCE HEALTH AND SERVICES WASHINGTON
413 LILLY RD NE
OLYMPIA, WA 985065133
3604934083
PROVIDENCE HEALTH AND SERVICES WASHINGTON
525 LILLY RD NE
OLYMPIA, WA 985065101
Source: CMS National Downloadable File, September 2026.