Medical school: WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2012
Offers telehealth
NPI: 1336415140
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
4805 NE GLISAN ST
PORTLAND, OR 972132933
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 454
PORTLAND, OR 972132984
5032156405
Source: CMS National Downloadable File, September 2026.