Graduated: 1994
NPI: 1588844112
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST
PORTLAND, OR 972132982
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 240
PORTLAND, OR 972132981
5032156480
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 454
PORTLAND, OR 972132984
5032156405
Source: CMS National Downloadable File, September 2026.