Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 1997
Also: INTERNAL MEDICINE
NPI: 1821017591
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
4805 NE GLISAN ST
PORTLAND, OR 972132933
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 240
PORTLAND, OR 972132981
5032156480
Source: CMS National Downloadable File, September 2026.