Graduated: 2021
NPI: 1871165118
Practice Locations (2)
MOUNTAIN PINE DERMATOLOGY PLLC
4664 N PENNGROVE WAY, SUITE 100
MERIDIAN, ID 836467442
2088987467
MOUNTAIN PINE DERMATOLOGY PLLC
3175 POCAHONTAS RD
BAKER CITY, OR 978141434
2088987467
Source: CMS National Downloadable File, September 2026.