Medical school: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2016
NPI: 1205269800
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES - OREGON
4805 NE GLISAN ST
PORTLAND, OR 972132933
5032151111
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 540
PORTLAND, OR 972132985
5032156600
Source: CMS National Downloadable File, September 2026.