Medical school: UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated: 1979
Offers telehealth
NPI: 1932180734
Practice Locations (1)
CONFEDERATED TRIBES OF THE GRAND RONDE COMMUNITY OF OREGON
9615 GRAND RONDE RD
GRAND RONDE, OR 973479712
5038792007
Source: CMS National Downloadable File, September 2026.