Medical school: NEW YORK MEDICAL COLLEGE
Graduated: 1999
Also: INTERNAL MEDICINE
NPI: 1295762946
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
10150 SE 32ND AVE
MILWAUKIE, OR 972226516
5035133613
PROVIDENCE HEALTH AND SERVICES - OREGON
4805 NE GLISAN ST
PORTLAND, OR 972132933
5032151111
Source: CMS National Downloadable File, September 2026.