Medical school: UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated: 1983
NPI: 1982613709
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES WASHINGTON
525 LILLY RD NE
OLYMPIA, WA 985065101
3604937230
SQUAXIN ISLAND TRIBE
90 SE KLAH CHE MIN DR
SHELTON, WA 985849216
3604279006
Source: CMS National Downloadable File, September 2026.