Graduated: 2021
NPI: 1558015099
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES - OREGON
1111 CRATER LAKE AVE
MEDFORD, OR 975046241
5417325250
SOUND PHYSICIANS INTENSIVISTS OF WASHINGTON PLLC
1111 CRATER LAKE AVE
MEDFORD, OR 975046241
5417325000
Source: CMS National Downloadable File, September 2026.