Graduated: 1996
NPI: 1518948447
Practice Locations (3)
TANANA VALLEY CLINIC LLC
1650 COWLES ST
FAIRBANKS, AK 997015907
9074593500
PEACEHEALTH
3100 TONGASS AVE
KETCHIKAN, AK 999015746
9072288300
PEACEHEALTH
1615 DELAWARE ST
LONGVIEW, WA 986322367
3606364814
Source: CMS National Downloadable File, September 2026.