Medical school: WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1996
Offers telehealth
NPI: 1306891742
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
10330 SE 32ND AVE, SUITE 205
MILWAUKIE, OR 972226594
5035138950
Source: CMS National Downloadable File, September 2026.