Medical school: OKLAHOMA STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated: 2012
NPI: 1962769802
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES - OREGON
9205 SW BARNES RD
PORTLAND, OR 972256603
5032162213
PROVIDENCE HEALTH AND SERVICES - OREGON
9205 SW BARNES RD, SUITE 20
PORTLAND, OR 972256603
5032162229
Source: CMS National Downloadable File, September 2026.