Medical school: UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Graduated: 2000
NPI: 1932148731
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES OREGON
171 N LARCH ST
CANNON BEACH, OR 971103103
5037177000
PROVIDENCE HEALTH AND SERVICES OREGON
725 S WAHANNA RD
SEASIDE, OR 971387735
5037177000
PROVIDENCE HEALTH AND SERVICES OREGON
727 S WAHANNA RD
SEASIDE, OR 971387735
5037177000
Source: CMS National Downloadable File, September 2026.