Graduated: 2001
NPI: 1205863487
Practice Locations (3)
ST ALPHONSUS PROFESSIONAL MEDICAL SERVICES LLC
1055 N CURTIS RD
BOISE, ID 837061309
2083672152
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
10180 SE SUNNYSIDE RD
CLACKAMAS, OR 970158970
8008132000
PROVIDENCE HEALTH AND SERVICE- WASHINGTON
101 W 8TH AVE
SPOKANE, WA 992042307
5094743131
Source: CMS National Downloadable File, September 2026.