Medical school: BAYLOR COLLEGE OF MEDICINE
Graduated: 1995
NPI: 1932285715
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
1200 E COLUMBIA AVE
COLVILLE, WA 991143354
5096843701
PROVIDENCE HEALTH AND SERVICES WASHINGTON
840 S MEYERS ST
KETTLE FALLS, WA 991417005
5096857848
Source: CMS National Downloadable File, September 2026.