Graduated: 2023
NPI: 1346952603
Practice Locations (4)
COUNTY OF LINCOLN
1105 SE JETTY AVE, SUITE C
LINCOLN CITY, OR 973672604
5412654947
COUNTY OF LINCOLN
36 SW NYE ST
Newport, OR 973653821
COUNTY OF LINCOLN
36 SW NYE ST
NEWPORT, OR 973653821
COUNTY OF LINCOLN
36 SWNYE ST
NEWPORT, OR 973653821
Source: CMS National Downloadable File, September 2026.