Graduated: 1991
NPI: 1679509111
Practice Locations (4)
2155 NW 173RD AVE, SUITE 102
BEAVERTON, OR 970063563
5035319990
PROVIDENCE HEALTH AND SERVICES OREGON
200 S HAZEL DELL WAY
CANBY, OR 970137829
2032639500
PROVIDENCE HEALTH AND SERVICES OREGON
10670 NE CORNELL RD
HILLSBORO, OR 971249221
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 240
PORTLAND, OR 972132981
5032156480
Source: CMS National Downloadable File, September 2026.