Graduated: 1997
NPI: 1770635930
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
128 LILLY RD NE, SUITE 205
OLYMPIA, WA 985067400
3067543380
1724 POINTE WOODWORTH DR NE
TACOMA, WA 984223480
2538206757
Source: CMS National Downloadable File, September 2026.