Medical school: WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1998
Offers telehealth
NPI: 1558387555
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.