Edstrom, Ingrid Large

Edstrom, Ingrid Large is an individual health care provider with primary practice located at 315 Goodpasture Island Rd , Eugene OR 97401-2109. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Edstrom, Ingrid Large can be contacted via phone (541) 302-2977.

Contact Information

Primary practice address
315 Goodpasture Island Rd Eugene OR 97401-2109
Phone: (541) 302-2977
Fax: (541) 302-6565
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1113222 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 200550045NPPP Oregon

Profile Details

NPI number 1689630410
LBN Legal business name Edstrom, Ingrid Large
Credentials BSN CFNP MED
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2006
Last updated Jul 16th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689630410 NPPES
Oregon MEDICAID 269858
Oregon Other 200550045NPPP
Oregon Other NP2194

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