Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 1995
NPI: 1649372756
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
1200 E COLUMBIA AVE
COLVILLE, WA 991143354
5096843701
PROVIDENCE HEALTH AND SERVICES WASHINGTON
9911 N NEVADA ST, SUITE 200
SPOKANE, WA 992181298
5096269420
Source: CMS National Downloadable File, September 2026.