Graduated: 2013
NPI: 1295170116
Practice Locations (2)
JEFFERSON COUNTY PUBLIC HOSPITAL DISTRICT NO 2
834 SHERIDAN ST
PORT TOWNSEND, WA 983682443
3603852200
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
1007 39TH AVE SE
PUYALLUP, WA 983742192
2534353100
Source: CMS National Downloadable File, September 2026.