Graduated: 1989
NPI: 1518012632
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
914 S SCHEUBER RD
CENTRALIA, WA 985319027
3607362803
404 BLACK HILLS LN SW D
Olympia, WA 985028148
404 BLACK HILLS LANE SW D
OLYMPIA, WA 985028148
3605282100
Source: CMS National Downloadable File, September 2026.