Medical school: UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Graduated: 1997
Offers telehealth
NPI: 1376571646
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 454
PORTLAND, OR 972132984
5032156405
Source: CMS National Downloadable File, September 2026.