Graduated: 2021
Offers telehealth
NPI: 1861104226
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
4805 NE GLISAN ST, SUITE 11N
PORTLAND, OR 972132933
5032156014
PROVIDENCE HEALTH AND SERVICES - OREGON
9205 SW BARNES RD
PORTLAND, OR 972256603
5032162213
Source: CMS National Downloadable File, September 2026.