Graduated: 2000
Offers telehealth
NPI: 1912987009
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
1321 NE 99TH AVE, SUITE 100
PORTLAND, OR 972209437
5032159900
PROVIDENCE HEALTH AND SERVICES - OREGON
4805 NE GLISAN ST
PORTLAND, OR 972132933
5032151111
Source: CMS National Downloadable File, September 2026.