Medical school: PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated: 1993
NPI: 1245254606
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES OREGON
200 S HAZEL DELL WAY
CANBY, OR 970137829
2032639500
PROVIDENCE HEALTH AND SERVICES OREGON
1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 972209439
5032154250
PROVIDENCE HEALTH AND SERVICES OREGON
16770 SW EDY RD, SUITE 102
SHERWOOD, OR 971409679
5032169600
Source: CMS National Downloadable File, September 2026.