Graduated: 2014
NPI: 1912303504
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES OREGON
200 S HAZEL DELL WAY
CANBY, OR 970137829
2032639500
PROVIDENCE HEALTH AND SERVICES OREGON
1321 NE 99TH AVE, SUITE 100
PORTLAND, OR 972209437
5032159900
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 240
PORTLAND, OR 972132981
5032156480
Source: CMS National Downloadable File, September 2026.