Graduated: 1990
NPI: 1225005721
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
413 LILLY RD NE
OLYMPIA, WA 985065133
3604934083
PROVIDENCE HEALTH AND SERVICES WASHINGTON
525 LILLY RD NE
OLYMPIA, WA 985065101
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
700 LILLY RD NE
OLYMPIA, WA 985065115
3609237000
Source: CMS National Downloadable File, September 2026.