Graduated: 2003
Offers telehealth
NPI: 1962784298
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES - OREGON
4805 NE GLISAN ST
PORTLAND, OR 972132933
5032151111
PROVIDENCE HEALTH AND SERVICES OREGON
9135 SW BARNES RD, SUITE 461
PORTLAND, OR 972256643
5032161150
Source: CMS National Downloadable File, September 2026.