Medical school: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2002
Offers telehealth
NPI: 1316993801
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 972209439
5032154250
Source: CMS National Downloadable File, September 2026.