Graduated: 2014
NPI: 1609266121
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
1200 E COLUMBIA AVE
COLVILLE, WA 991143354
5096843701
COLVILLE MEDICAL CENTER PS
1200 E COLUMBIA AVE
COLVILLE, WA 991143354
Source: CMS National Downloadable File, September 2026.