Graduated: 2003
NPI: 1720226202
Practice Locations (2)
GUAM HEALTHCARE DEVELOPMENT INCORPORATED
133 ROUTE 3
DEDEDO, GU 969296911
6716455500
PROVIDENCE HEALTH AND SERVICES WASHINGTON
413 LILLY RD NE
OLYMPIA, WA 985065133
3604934083
Source: CMS National Downloadable File, September 2026.