Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1376628248 Individual Practitioner Female Practitioner

Jackie L. Ingram , LMP

Specialist • Olympia, WA

Professional Overview & Biography Verified Profile Summary

Jackie Ingram, LMP is a registered healthcare professional specializing in Specialist in Olympia, WA. Practice services are available at 3912 MARTIN WAY E SUITE B under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3912 Martin Way E Suite B

Olympia, WA 98506

Telephone 3604599780
Fax 3604120581
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Olympia, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 36.3 Yrs
State Avg: 35.4 Yrs
Regional Practice Density
114 Specialists

Practicing in Olympia, WA (2751 Statewide)

Telehealth Adoption Rate
1.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License WA MA00011670

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Regence Blue Shield
IN7892 (WA)
Commercial Insurance / Payer ID Dept. Of Labor & Ind.
125710 (AL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

13 Associated Practitioners
Jessica Batson , LMT

Massage Therapist

NPI 1083195598

Licensed Massage Therapist

NPI 1154484863

Licensed Massage Practitioner, Licensed Physical Therapist Assistant

Mary Hanneman , LMP

Massage Therapist

NPI 1154488435

Licensed Massage Practitioner

Lisa Haglund , LMP

Massage Therapist

NPI 1306065933

Licensed Massage Practitioner

Juanita Whalen , MA

Massage Therapist

NPI 1427667005

Master of Arts

NPI 1558428672

Licensed Massage Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 3912 MARTIN WAY E SUITE B, OLYMPIA, WA 98506 (Tel: 3604599780)

📍
Updated Business Mailing Address July 08, 2007

Registered at 460 W BULB FARM RD, SHELTON, WA 985849154 (Tel: 3604906490)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JACKIE INGRAM, LMP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #MA00011670 in WA)

🟢
Initial NPI Registration & Enumeration October 26, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Jackie Ingram. Be the first to share your experience!

Sign in to leave a review for Jackie Ingram

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1376628248
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 26, 2006
Last Update: July 21, 2022
Sole Proprietor: Yes

Mailing Address

460 W Bulb Farm Rd

Shelton, WA 985849154

Phone: 3604906490

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.