Medical school: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2024
NPI: 1215722186
Practice Locations (2)
1760 SW 3RD ST, LEVEL 11 NUTRITION LLC
Corvallis, OR 973331725
1760 SW 3RD ST
CORVALLIS, OR 973331725
8445383511
Source: CMS National Downloadable File, September 2026.