Graduated: 1993
NPI: 1427006576
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
725 S WAHANNA RD
SEASIDE, OR 971387735
5037177000
PROVIDENCE HEALTH AND SERVICES OREGON
727 S WAHANNA RD
SEASIDE, OR 971387735
5037177000
Source: CMS National Downloadable File, September 2026.