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1942262589
PHILLIP RANDALL INGRAM
TACOMA, WA
NPI
1942262589
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: WA PA10002587)
Enumeration Date
2006-04-06
Last Update Date
2007-07-08
Business Address
Mr. PHILLIP RANDALL INGRAM PAC
9600 VETERANS DR SW
TACOMA, WA 98493-0003
Phone number: 253-582-8440
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Mailing Address
Mr. PHILLIP RANDALL INGRAM PAC
16809 88TH STREET KPS
LONGBRANCH, WA 98351-9521
Phone number: 253-884-4315
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