Medical school: UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduated: 2012
NPI: 1700146891
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
10150 SE 32ND AVE
MILWAUKIE, OR 972226516
5035133613
LEGACY CLINICS LLC
19300 SW 65TH AVE, MERIDIAN PARK HOSP
PORTLAND, OR 970627706
5036921212
Source: CMS National Downloadable File, September 2026.