Graduated: 2023
NPI: 1699450007
Practice Locations (2)
ST ALPHONSUS PROFESSIONAL MEDICAL SERVICES LLC
1055 N CURTIS RD
BOISE, ID 837061309
2083672152
PROVIDENCE HEALTH AND SERVICE- WASHINGTON
101 W 8TH AVE
SPOKANE, WA 992042307
5094743131
Source: CMS National Downloadable File, September 2026.