Medical school: UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduated: 2004
Offers telehealth
NPI: 1528250131
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
417 SW 117TH AVE
PORTLAND, OR 972255924
PROVIDENCE HEALTH AND SERVICES OREGON
9205 SW BARNES RD
PORTLAND, OR 972256603
Source: CMS National Downloadable File, September 2026.