Graduated: 2023
Offers telehealth
NPI: 1235823857
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 117
PORTLAND, OR 972132955
5032151874
KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
19185 SW 90TH AVE
TUALATIN, OR 970627558
8008132000
Source: CMS National Downloadable File, September 2026.