Graduated: 2021
NPI: 1316516073
Practice Locations (2)
1305 MANSFIELD ST, SUITE 4
RICHLAND, WA 993523588
5099469124
PROVIDENCE HEALTH AND SERVICES - WASHINGTON
1025 S 2ND AVE
WALLA WALLA, WA 993624116
5098973000
Source: CMS National Downloadable File, September 2026.