Medical school: UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Graduated: 2007
NPI: 1629336029
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICE- WASHINGTON
401 W POPLAR ST
WALLA WALLA, WA 993622846
5098973320
Source: CMS National Downloadable File, September 2026.