Graduated: 2005
NPI: 1245587823
Practice Locations (4)
PROVIDENCE HEALTH AND SERVICES OREGON
440 NW DIVISION ST
GRESHAM, OR 970305506
5032159500
THE OREGON CLINIC, PC
4805 NE GLISAN, 6N60
PORTLAND, OR 972132933
5032810561
PROVIDENCE HEALTH AND SERVICES OREGON
4805 NE GLISAN ST
PORTLAND, OR 972132933
PROVIDENCE HEALTH AND SERVICES OREGON
113 S HWY 101
WARRENTON, OR 971469314
5038616500
Source: CMS National Downloadable File, September 2026.