Graduated: 2015
NPI: 1851760904
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
9290 SE SUNNYBROOK BLVD, SUITE 120
CLACKAMAS, OR 970156802
5032152110
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 240
PORTLAND, OR 972132981
5032156480
Source: CMS National Downloadable File, September 2026.