| James W Ingersoll Phd Inc Ps | |
|
1115 Olympia Ave Ne Olympia WA 98506-4035 | |
| (360) 561-5730 | |
| Not Available |
| Full Name | James W Ingersoll Phd Inc Ps |
|---|---|
| Speciality | Psychologist |
| Location | 1115 Olympia Ave Ne, Olympia, Washington |
| Authorized Official Name and Position | James W Ingersoll (PSYCHOLOGIST/PRESIDENT) |
| Authorized Official Contact | 3605615730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James W Ingersoll Phd Inc Ps 1115 Olympia Ave Ne Olympia WA 98506-4035 Ph: (360) 561-5773 | James W Ingersoll Phd Inc Ps 1115 Olympia Ave Ne Olympia WA 98506-4035 Ph: (360) 561-5730 |
| NPI Number | 1932595303 |
|---|---|
| Provider Enumeration Date | 04/12/2015 |
| Last Update Date | 04/12/2015 |
| Medicare PECOS PAC ID | 6608195854 |
|---|---|
| Medicare Enrollment ID | O20150511000214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932595303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 446 (Washington) | Primary |
| Provider Name | James W Ingersoll |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487690715 PECOS PAC ID: 1951373174 Enrollment ID: I20040809001030 |
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