Medical school: OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1997
Offers telehealth
NPI: 1629004155
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
12345 SW HORIZON BLVD, SUITE 57
BEAVERTON, OR 970079475
5032168820
Source: CMS National Downloadable File, September 2026.