Ingram, Jonathan

Ingram, Jonathan is an individual health care provider with primary practice located at 1550 S Pioneer Way Ste 165 , Moses Lake WA 98837-4637. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Ingram, Jonathan can be contacted via phone (509) 793-9780.

Contact Information

Primary practice address
1550 S Pioneer Way Ste 165 Moses Lake WA 98837-4637
Phone: (509) 793-9780
Fax: (509) 764-3246
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AP60491883 Washington

Profile Details

NPI number 1336557867
LBN Legal business name Ingram, Jonathan
Credentials PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2014
Last updated Mar 19th, 2021 - about 4 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 1336557867 NPPES
Washington MEDICAID 2038198
Washington Other G8994731

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