Ingram, Shirley Blaine
Ingram, Shirley Blaine is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd Ohsu Div Arthritis And Rheum Dis Op09, Portland OR 97239-3011. She recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as her primary health care specialty. Ingram, Shirley Blaine can be contacted via phone (503) 494-8637.Contact Information
Primary practice address
3181 Sw Sam Jackson Park Rd Ohsu Div Arthritis And Rheum Dis Op09
Portland OR 97239-3011
Phone: (503) 494-8637
Fax: (503) 494-1022
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | MD12875 | Oregon |
Profile Details
| NPI number | 1700062353 |
|---|---|
| LBN Legal business name | Ingram, Shirley Blaine |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 14th, 2008 |
| Last updated | Oct 5th, 2011 - about 14 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 | 1700062353 | NPPES |
| Oregon | MEDICAID | 285056 |
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