Graduated: 2019
NPI: 1619517414
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
914 S SCHEUBER RD
CENTRALIA, WA 985319027
3607362803
CAPITAL MEDICAL CENTER SPECIALTY PHYSICIANS LLC
3900 CAPITAL MALL DR SW
OLYMPIA, WA 985028654
3607044743
Source: CMS National Downloadable File, September 2026.