Medical school: LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated: 2003
Offers telehealth
NPI: 1851402481
Practice Locations (1)
PROVIDENCE HEALTH AND SERVICES OREGON
5330 NE GLISAN ST, SUITE 100
PORTLAND, OR 972133069
5032159700
Source: CMS National Downloadable File, September 2026.