Medical school: UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
Graduated: 1982
NPI: 1902842081
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES - OREGON
9205 SW BARNES RD
PORTLAND, OR 972256603
5032162213
PROVIDENCE HEALTH AND SERVICES - OREGON
9205 SW BARNES RD, SUITE 20
PORTLAND, OR 972256603
5032162229
Source: CMS National Downloadable File, September 2026.