Medical school: UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated: 1994
NPI: 1689760506
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES OREGON
1619 NW HAWTHORNE AVE, SUITE 206
GRANTS PASS, OR 975266009
5417327850
PROVIDENCE HEALTH AND SERVICES OREGON
1111 CRATER LAKE AVE
MEDFORD, OR 975046241
5417325545
PROVIDENCE HEALTH AND SERVICES OREGON
940 ROYAL AVE
MEDFORD, OR 975046194
Source: CMS National Downloadable File, September 2026.