Graduated: 2011
Offers telehealth
NPI: 1861781767
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES - OREGON
4805 NE GLISAN ST
PORTLAND, OR 972132933
5032151111
PROVIDENCE HEALTH AND SERVICES OREGON
4805 NE GLISAN ST, SUITE 11N
PORTLAND, OR 972132933
5032156014
Source: CMS National Downloadable File, September 2026.