Individual
IAN INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4725 NE MASON ST, PORTLAND, OR 97218-1744
(208) 272-1085
Mailing address
4725 NE MASON ST, PORTLAND, OR 97218-1744
(208) 272-1085
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH0018334
OR
Other
Enumeration date
08/14/2024
Last updated
08/14/2024
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