Ingram, Diana
Ingram, Diana is an individual health care provider with primary practice located at 1400 Pottery Ave , Port Orchard WA 98366-3711. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Ingram, Diana can be contacted via phone (360) 895-5000.Contact Information
Primary practice address
1400 Pottery Ave
Port Orchard WA 98366-3711
Phone: (360) 895-5000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT00008192 | Washington |
Profile Details
| NPI number | 1679628804 |
|---|---|
| LBN Legal business name | Ingram, Diana |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 25th, 2007 |
| Last updated | Jul 25th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679628804 | NPPES |
| Washington | MEDICAID | 8337669 |
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