Active NPI
Robin A Ingraham, PT
- Physical Therapist
- Granite Falls, WA
National Provider Identifier
1891735403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 403 W Stanley St
Granite Falls, WA 98252-8631 - Phone
- (360) 691-4835
- Fax
- (360) 691-2545
- NPI assigned
- Jun 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
403 W Stanley St
Granite Falls, WA 98252-8631
Mailing address
1519 132ND St SE
Suite a
Everett, WA 98208-7203
Phone (425) 330-0633
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8336463 | Medicaid | WA | |
| 911745305-98252-B003 | Other | WA | TRICARE |
| 0128226 | Other | WA | LABOR & INDUSTRY |
| 7491IN | Other | WA | REGENCE BLUE SHIELD |
| 5085695 | Other | WA | AETNA |
| Q4WYR1 | Other | WA | EMPIRE BC,BS |
| 8928858 | Other | WA | L&I CRIME VICTIMS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191974400000",
"number": "1891735403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1519 132ND ST SE",
"address_2": "SUITE A",
"city": "EVERETT",
"state": "WA",
"postal_code": "982087203",
"telephone_number": "425-330-0633",
"fax_number": "425-338-9637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 W STANLEY ST",
"city": "GRANITE FALLS",
"state": "WA",
"postal_code": "982528631",
"telephone_number": "360-691-4835",
"fax_number": "360-691-2545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAHAM",
"first_name": "ROBIN",
"middle_name": "A",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-08",
"last_updated": "2007-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8336463",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "911745305-98252-B003",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRY",
"identifier": "0128226",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "7491IN",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5085695",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC,BS",
"identifier": "Q4WYR1",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I CRIME VICTIMS",
"identifier": "8928858",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Granite Falls, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.