Graduated: 2020
NPI: 1790374536
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES OREGON
4805 NE GLISAN ST
PORTLAND, OR 972132933
PROVIDENCE HEALTH AND SERVICES - OREGON
4805 NE GLISAN ST
PORTLAND, OR 972132933
5032151111
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 240
PORTLAND, OR 972132981
5032156480
Source: CMS National Downloadable File, September 2026.