Provider Demographics
NPI:1720062615
Name:INGRAM, ESTHER YBARRA (RPH)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:YBARRA
Last Name:INGRAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10625 NE 68TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7054
Mailing Address - Country:US
Mailing Address - Phone:425-822-2241
Mailing Address - Fax:
Practice Address - Street 1:10625 NE 68TH ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7054
Practice Address - Country:US
Practice Address - Phone:425-822-2241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-03
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00013668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist