Graduated: 1991
NPI: 1952482317
Practice Locations (3)
PROVIDENCE HEALTH AND SERVICES OREGON
1332 S SHASTA AVE, SUITE A
EAGLE POINT, OR 975248623
5418268160
PROVIDENCE HEALTH AND SERVICES OREGON
940 ROYAL AVE
MEDFORD, OR 975046194
PROVIDENCE HEALTH AND SERVICES OREGON
965 ELLENDALE DR
MEDFORD, OR 975048215
5417326000
Source: CMS National Downloadable File, September 2026.