Graduated: 1995
NPI: 1912929258
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
1620 COOPER POINT RD SW
OLYMPIA, WA 985025736
3064866710
PROVIDENCE HEALTH AND SERVICES WASHINGTON
525 LILLY RD NE
OLYMPIA, WA 985065101
Source: CMS National Downloadable File, September 2026.