Graduated: 2011
NPI: 1184785727
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 972209439
5032154250
CASCADIA HEALTH
4212 SE DIVISION ST, SUITE 100
PORTLAND, OR 972061680
5032367166
Source: CMS National Downloadable File, September 2026.