Graduated: 2007
NPI: 1427293208
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES OREGON
1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 972209439
5032154250
PROVIDENCE HEALTH AND SERVICES OREGON
417 SW 117TH AVE
PORTLAND, OR 972255924
PROVIDENCE HEALTH AND SERVICES - OREGON
4805 NE GLISAN ST
PORTLAND, OR 972132933
5032151111
Source: CMS National Downloadable File, September 2026.