Medical school: ROCKY VISTA UNIVERSITY COLLEGE OF OSTEOPATHIC MED
Graduated: 2013
NPI: 1992046825
Practice Locations (2)
PROVIDENCE HEALTH AND SERVICES - OREGON
4805 NE GLISAN ST
PORTLAND, OR 972132933
5032151111
PROVIDENCE HEALTH AND SERVICES OREGON
5050 NE HOYT ST, SUITE 610
PORTLAND, OR 972132985
5034674761
Source: CMS National Downloadable File, September 2026.