Graduated: 1994
NPI: 1174854764
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
914 S SCHEUBER RD
CENTRALIA, WA 985319027
3607362803
PROVIDENCE HEALTH AND SERVICES WASHINGTON
413 LILLY RD NE
OLYMPIA, WA 985065133
3604919480
Source: CMS National Downloadable File, September 2026.