Medical school: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2004
NPI: 1346432721
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
1111 CRATER LAKE AVE
MEDFORD, OR 975046241
5417326274
PROVIDENCE HEALTH AND SERVICES OREGON
9205 SW BARNES RD, SUITE MT2159
PORTLAND, OR 972256603
5032152669
Source: CMS National Downloadable File, September 2026.