Graduated: 1996
NPI: 1245280494
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES - WASHINGTON
1111 S 2ND AVE
WALLA WALL, WA 993624118
5098973700
PROVIDENCE HEALTH AND SERVICES - WASHINGTON
380 CHASE AVE
WALLA WALLA, WA 993622924
5098973333
Source: CMS National Downloadable File, September 2026.