Graduated: 2017
NPI: 1801300165
Practice Locations (2)
DHS OFFICE OF FINANCIAL SERVICES IRS EOPC BMRC EOTC OSH OSH-P
2600 CTR ST NE
SALEM, OR 973012669
5039452800
PEACEHEALTH
1615 DELAWARE ST
LONGVIEW, WA 986322367
3606364814
Source: CMS National Downloadable File, September 2026.