Individual
BETHANY INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2355 STATE ST STE 101, SALEM, OR 97301-4541
(503) 427-8104
(503) 447-8676
Mailing address
PO BOX 96022, PORTLAND, OR 97296-6000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/28/2013
Last updated
03/09/2023
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