Medical school: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated: 1990
NPI: 1528153228
Practice Locations (4)
PROVIDENCE HEALTH AND SERVICES OREGON
1321 NE 99TH AVE, SUITE 200
PORTLAND, OR 972209439
5032154250
PROVIDENCE HEALTH AND SERVICES OREGON
9205 SW BARNES RD
PORTLAND, OR 972256603
PROVIDENCE HEALTH AND SERVICES - OREGON
9205 SW BARNES RD
PORTLAND, OR 972256603
5032162213
PROVIDENCE HEALTH AND SERVICES - OREGON
9205 SW BARNES RD, SUITE 20
PORTLAND, OR 972256603
5032162229
Source: CMS National Downloadable File, September 2026.