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General NPI Number Information
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NPI Number | 1538327838
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Entity Type | Individual
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Provider Name | INGRID A CHERRYTREE MD
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Gender | Female
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Dates
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Enumeration Date | 05/23/2008
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Last Update Date | 03/14/2017
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Provider Practice Location Address
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Address Line | 9135 SW BARNES RD STE 761
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City | PORTLAND
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State | OR
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Zip | 97225-6646
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Country | US
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Telephone | 503-216-2602
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3158 MS:M4-PFS
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City | PORTLAND
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State | OR
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Zip | 97208-3158
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD164171
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | MD60284993
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License Number State | WA
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