Dr. Jeffry A. Goldes, M.D.
General Dermatology, Anatomic Pathology and Dermatopathology.
Dr. Goldes was an Army brat born in Honolulu, Hawaii. He graduated with honors from Boston University School of Medicine and is a member of Alpha Omega Alpha, the medical honor society. He received training in Anatomic Pathology, General Dermatology and Dermatopathology at the University of Washington, Seattle, and the University of Minnesota, Minneapolis.
Following residency training, Dr. Goldes was assigned to Andrews Air Force Base, Maryland, and the Armed Forces Institute of Pathology, Washington, D.C. He was then in private practice in Washington, D.C. He has been in Helena since 1990.
In addition to his clinical patients at Associated Dermatology, Dr. Goldes sees patients on a volunteer basis through the Cooperative Health Center, the Leo Pocha Clinic and God’s Love Homeless Shelter. Dr. Goldes also serves as a Consultant Dermatologist at St. Peter’s Hospital.
Jody Isbell, PA-C, MPAS
Jody is a Certified Physician Assistant raised in Helena who graduated from Carroll College with a bachelor’s degree in Biology. She obtained her master’s degree in Physician Assistant Studies at Idaho State University in 2009. A Diplomate Fellow with the Society of Dermatology Physician Assistants, she loves the challenging nature of dermatology and collaborating with other providers to optimize patient care. Additionally, she has over 7 years of experience in a thriving orthopedic clinic. She enjoys mountain biking, skiing/snowboarding, community theater, crafting, and spending time with her family. Jody joined the clinic in 2016.
Julie Flesch, FNP-BC
Julie Flesch grew up all around the world but has called Montana HOME since she moved to Butte in 1982. She received a Bachelor of Science in Business Administration from Eastern Montana College (1992) in Billings, and then went on to graduate with a Bachelor of Science in Nursing (2000) and her Master’s Degree in Nursing (2011) from Montana State University. She worked most of her RN career in the Emergency Department in Great Falls and Billings. She practiced family medicine for 6+ years and Phlebology for 3 years before joining Associated Dermatology. She has a teenaged son and is engaged to her greatest friend, Buel.
Julie enjoys spending time at their cabin, spending time on their surf boat, and generally being outdoors and active! She has a special passion for our military members, and especially for the Montana Air National Guard. She enjoys meeting new people and learning about their experiences.
Leigha Shilhanek, DNP, FNP-C, DCNP
Leigha Shilhanek was born and raised in Billings and attended Carroll College for her bachelor’s degree in Nursing. She worked as a nurse for 7 years in cardiology and intensive care before graduating with her Doctorate in Nursing from Arizona State University in 2018. Leigha completed a dermatology fellowship and worked for several years as a Nurse Practitioner at a large dermatology practice in Arizona before being called home to Montana. She is excited to return with her husband and young son to enjoy all the mountain state has to offer. Leigha enjoys hiking, skiing, reading, and cooking. She is passionate about the prevention and early detection of skin cancer and enjoys helping patients feel confident in their skin.
Ruby Greer, DNP, APRN, WHNP-BC
Ruby Greer boasts over 15 years of invaluable experience within the healthcare industry. Her journey began with a Bachelor of Science in Nursing from Montana State University, eventually leading her to pursue both a Master’s and Doctorate in Nursing from Frontier University’s School of Nursing.
Ruby is passionate about empowering individuals to make informed decisions about their health and wellness. She has extensive experience in providing a range of services such as preventative health visits, common and complex gynecologic and reproductive health conditions, menopause transition and postmenopausal care, and addressing women’s and men’s non-gynecologic primary health needs, including bioidentical hormone replacement therapy.
Ruby is committed to providing high-quality, compassionate care to her patients. She strongly believes in building strong relationships with her patients and working collaboratively to develop personalized care plans that meet their unique needs. In her free time, Ruby enjoys exploring the mountains, laughing, and watching as many sunsets as she can with her family.
Billie Orchard, Board Certified Radiation Therapist
Billie is a Board Certified Radiation Therapist. She attended Montana State University and furthered her education in radiation at Weber State in Ogden, Utah. She is board certified in radiologic technology as well as radiographic and computer tomography. Her priority is helping patients understand the non-surgical cure for non-melanoma skin cancers. Billie was raised on a cattle ranch in the heart of the Big Horn mountains in Ten Sleep, Wyoming. She grew to love small towns and outdoor activities. Billie has lived in Helena for 18 years and enjoys spending time with her husband and son.
Triston Lytle, Practice Administrator
Triston Lytle was born and raised in Montana. He has always felt a strong connection to the outdoors, and there’s nothing he enjoys more than spending time outside with his family. Whether it’s camping in the mountains, hiking new trails, fishing on a quiet lake, or heading out for a hunt, being in nature helps him recharge and stay grounded. Triston has worked in healthcare leadership for several years, supporting teams, streamlining operations, and helping improve the patient experience. He is passionate about leading by example, building strong teams, and finding practical solutions to everyday challenges. Outside work, Triston is all about living fully, making memories with his family, and enjoying the incredible Montana lifestyle.
Debi Simon, Office Manager
Associated Dermatology and Advanced Laser Clinic’s Office Manager, Debi, has experience in numerous administrative roles in the private as well as corporate industries for over 40 years. Debi joined the Clinic in 2018. She enjoys being outdoors, camping, fishing, walking, and hiking in this beautiful state we all call home, Montana!
Janel Zitzka, LPN, Director of Advanced Laser Clinic
Janel Zitzka, LPN, is the Director of the Advanced Laser Clinic at Associated Dermatology in Helena and is recognized as one of Montana’s leading laser and injectable specialists. Since joining the practice in 2010, she has played a key role in developing the laser program, helping bring in and implement cutting-edge technology — including the Opus plasma system and multiple state-of-the-art laser platforms. With more than 55 certifications in laser and injectable procedures, Janel’s expertise spans vascular laser treatments, photorejuvenation, radiofrequency therapies, advanced neuromodulator and filler injections, and a wide range of skin care technologies. Her depth of training and hands-on experience make her a trusted provider for patients seeking advanced cosmetic and corrective treatments.
Outside of the clinic, Janel enjoys raising French Bulldogs, cooking for friends and family, and taking in Montana’s scenic beauty from her countryside home near Helena.
Tracy Vidrich, RN
Tracy is a dedicated healthcare professional who joined Associated Dermatology in 2010. Her commitment to excellence and unwavering dedication to patient care has made her an integral part of the clinic’s team.
Tracy’s expertise extends to various facets of healthcare, including dermatology and hormone therapy. She is a certified BioTe nurse with specialized knowledge and skills in bioidentical hormone replacement therapy.
Megan Roope, CCMA, Medical Staff Manager
Megan Roope is the Medical Staff Manager at Associated Dermatology in Helena, Montana. Born and raised in Glendive, she went on to study at Helena College, where she became a nationally certified medical assistant. Megan first joined the clinic in 2014 as a medical receptionist and quickly discovered her passion for patient care, leading her to further her education and advance into clinical leadership. In her current role, Megan oversees the nursing and medical assistant teams and works closely with providers to ensure every patient receives high-quality, compassionate care. She especially values the opportunity to build personal connections with patients and support them through their dermatologic care experience.
Outside of work, Megan enjoys camping, spending time outdoors, and traveling around Montana with her husband and their two children.
Lu Lobbestael
Lu serves as the Reception Manager at Associated Dermatology, where she leads and supports the front office team responsible for answering phones, scheduling patients, and managing provider calendars. With more than 15 years of experience in customer service — beginning in the airline industry as a ground service agent and trainer — she brings both efficiency and a patient-first mindset to the clinic’s daily operations. She holds a degree in Cultural Anthropology and has traveled extensively, combining her academic interests with real-world experiences around the globe. Lu enjoys applying her understanding of culture and human behavior to both her work in healthcare and her love of Montana history.
When she’s not traveling, Lu can be found running or hiking the hills around Helena with her partner and best friend.