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Jackie L. Ingram, LMP
Specialist in Olympia, Washington
NPI 1376628248

Jackie L. Ingram is a Specialist based in Shelton, WA. Jackie L. Ingram practices in Olympia, WA and has the professional credentials of LMP. The NPI Number for Jackie L. Ingram is 1376628248 and holds a License No. MA00011670 (Washington).

The current practice location address for Jackie L. Ingram is 3912 Martin Way E Suite B, Olympia, WA and can be reached out via phone at 360-459-9780 and via fax at 360-412-0581.

Location: 3912 Martin Way E Suite B, Olympia, WA, 98584-9154
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1376628248
Provider Name
Jackie L. Ingram
Credential
LMP
Provider Entity Type
Individual
Gender
Female
Address
3912 Martin Way E Suite B, Olympia, WA, 98584-9154
Phone Number
360-459-9780
Fax Number
360-412-0581
Provider Enumeration Date
10/26/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
IN7892 01 WA REGENCE BLUE SHIELD
125710 01 AL DEPT. OF LABOR & IND.
institution
Provider Business Practice Location Address Details
Address
3912 Martin Way E Suite B
City
Olympia
State
Washington
Zip
98506
Phone Number
360-459-9780
Fax Number
360-412-0581
person
Provider Business Mailing Address Details
Address
3912 Martin Way E Suite B
City
Olympia
State
Washington
Zip
98506
Phone Number
360-459-9780
Fax Number
360-412-0581
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
MA00011670 (Washington)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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