Graduated: 2008
NPI: 1174780282
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
413 LILLY RD NE
OLYMPIA, WA 985065133
3604919480
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
700 LILLY RD NE
OLYMPIA, WA 985065115
3609237000
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
9505 S STEELE ST
TACOMA, WA 984441858
2535976800
Source: CMS National Downloadable File, September 2026.