Medical school: WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Graduated: 2007
Offers telehealth
NPI: 1720208556
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
9155 SW BARNES RD, SUITE 238
PORTLAND, OR 972256629
5032160246
Source: CMS National Downloadable File, September 2026.