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1336557867
JONATHAN INGRAM
MOSES LAKE, WA
NPI
1336557867
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: WA AP60491883)
Enumeration Date
2014-07-28
Last Update Date
2021-03-19
Business Address
JONATHAN INGRAM PMHNP
1550 S PIONEER WAY STE 165
MOSES LAKE, WA 98837-4637
Phone number: 509-793-9780
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Mailing Address
JONATHAN INGRAM PMHNP
660 S COOLIDGE ST
MOSES LAKE, WA 98837-1872
Phone number: 509-793-9715
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