Graduated: 1998
NPI: 1215206941
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
4800 COLLEGE ST SE
LACEY, WA 985034389
3604862900
PROVIDENCE HEALTH AND SERVICES WASHINGTON
525 LILLY RD NE
OLYMPIA, WA 985065101
Source: CMS National Downloadable File, September 2026.