Medical school: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1995
NPI: 1487647624
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST
PORTLAND, OR 972132982
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 454
PORTLAND, OR 972132984
5032156405
Source: CMS National Downloadable File, September 2026.