Graduated: 1982
NPI: 1215917992
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES OREGON
1111 CRATER LAKE AVE
MEDFORD, OR 975046241
5417325545
PROVIDENCE HEALTH AND SERVICES OREGON
1698 E MCANDREWS RD
MEDFORD, OR 975045590
PROVIDENCE HEALTH AND SERVICES OREGON
940 ROYAL AVE
MEDFORD, OR 975046194
Source: CMS National Downloadable File, September 2026.