Graduated: 2022
NPI: 1356050744
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
1000 S SCHEUBER RD
CENTRALIA, WA 985318877
3603308950
PROVIDENCE HEALTH AND SERVICES WASHINGTON
525 LILLY RD NE
OLYMPIA, WA 985065101
Source: CMS National Downloadable File, September 2026.