Medical school: ARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY
Graduated: 2012
NPI: 1609139260
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
525 LILLY RD NE
OLYMPIA, WA 985065101
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
700 LILLY RD NE
OLYMPIA, WA 985065115
3609237000
Source: CMS National Downloadable File, September 2026.