Medical school: MEDICAL COLLEGE OF WISCONSIN
Graduated: 2022
NPI: 1760131445
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES - OREGON
9205 SW BARNES RD
PORTLAND, OR 972256603
5032162213
PROVIDENCE HEALTH AND SERVICES - OREGON
9205 SW BARNES RD, SUITE 20
PORTLAND, OR 972256603
5032162229
Source: CMS National Downloadable File, September 2026.