Graduated: 2020
NPI: 1447865464
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
1111 CRATER LAKE AVE
MEDFORD, OR 975046241
5417325545
PAIN RELIEF INSTITUTE LLC
1411 E MCANDREWS RD
MEDFORD, OR 975046107
5417731435
Source: CMS National Downloadable File, September 2026.