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NPI Profile for PROVIDENCE HEALTH SERVICES WASHINGTON in ENTERPRISE, OR.
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Cardiovascular Disease |
207RC0000X | 11 | Physician/Internal Medicine |
| NPI # | 1144536269 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/26/2010 | |
| Last updated | 08/01/2025 - About 10 months ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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PROVIDENCE HEALTH & SERVICES - WASHINGTON
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PROVIDENCE HEALTH & SERVICES - WASHINGTON