Individual
PAUL R. INGRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1108 JUNE ST, HOOD RIVER, OR 97031-1513
(541) 387-6125
Mailing address
PO BOX 3390, PORTLAND, OR 97208-3390
(503) 215-6019
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
17747
AZ
207R00000X
Internal Medicine Physician
Primary
MD216510
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276718
—
AZ
Enumeration date
01/18/2006
Last updated
10/27/2023
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