Medical school: OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated: 1994
Offers telehealth
NPI: 1194803718
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
12345 SW HORIZON BLVD, SUITE 57
BEAVERTON, OR 970079475
5032168820
Source: CMS National Downloadable File, September 2026.