Graduated: 1998
NPI: 1376875740
Practice Locations (3)
1420 NW 14TH PL
Corvallis, OR 973304624
5060 SW PHILOMATH BLVD, SUITE 218
CORVALLIS, OR 973331044
529 NW 4TH ST
CORVALLIS, OR 973306410
5039366163
Source: CMS National Downloadable File, September 2026.