Graduated: 2020
NPI: 1720684392
Practice Locations (4)
NORTHEASTERN RURAL HEALTH CLINICS
1850 SPRING RIDGE DR
SUSANVILLE, CA 961306100
53025150001515
PROVIDENCE HEALTH AND SERVICES WASHINGTON
1010 S SCHEUBER RD
CENTRALIA, WA 985318892
3608277966
PROVIDENCE HEALTH AND SERVICES WASHINGTON
1010 S SCHEUBER RD, SUITE 3/4
CENTRALIA, WA 985318892
3608277966
PROVIDENCE HEALTH AND SERVICES WASHINGTON
525 LILLY RD NE
OLYMPIA, WA 985065101
Source: CMS National Downloadable File, September 2026.