MS. Shannon Michelle Ingrum, LMP

NPI #1265791750 in Arlington, Washington

Provider Information

NPI Number: 1265791750
Entity Type: Individual
Name: MS. Shannon Michelle Ingrum, LMP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: LMP
Enumeration Date: May 3, 2012
Last Updated: May 3, 2012

Practice Location

Address: 6210 209TH ST NE
City: Arlington
State: Washington
ZIP Code: 98223-4253
Phone: (360) 631-9955

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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