Graduated: 2000
Offers telehealth
NPI: 1972639276
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES OREGON
1111 CRATER LAKE AVE
MEDFORD, OR 975046241
5417325545
PROVIDENCE HEALTH AND SERVICES OREGON
940 ROYAL AVE
MEDFORD, OR 975046194
Source: CMS National Downloadable File, September 2026.