Medical school: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1986
NPI: 1184606295
Practice Locations (3)
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
5032151111
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 611
PORTLAND, OR 972132990
5032158699
Source: CMS National Downloadable File, September 2026.