Graduated: 1993
NPI: 1891767190
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
1200 E COLUMBIA AVE
COLVILLE, WA 991143354
5096843701
PROVIDENCE HEALTH AND SERVICES WASHINGTON
212 E CENTRAL AVE
SPOKANE, WA 992086290
Source: CMS National Downloadable File, September 2026.