Graduated: 2007
NPI: 1801030382
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES - OREGON
1111 CRATER LAKE AVE
MEDFORD, OR 975046241
5417325250
PROVIDENCE HEALTH AND SERVICES OREGON
1111 CRATER LAKE AVE
MEDFORD, OR 975046241
5417325545
SWEDISH HEALTH SERVICES
747 BROADWAY
SEATTLE, WA 981224379
2063866000
Source: CMS National Downloadable File, September 2026.