Individual ProviderGlenn KelloggAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address104 West 5th, Ste 250e, Spokane, WA 99204(509) 838-1547(509) 838-8610PECOS EnrollmentBased on the most recent information from CMS, provider Glenn Kellogg is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1689685547Provider TypeIndividualFull NameKellogg, GlennTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date8/10/2006Last Updated12/17/2007Contact InformationPractice LocationPractice Address104 West 5th, Ste 250e, Spokane, WA 99204Phone(509) 838-1547Fax(509) 835-4058Mailing LocationMailing Address104 West 5th, Ste 250e, Spokane, WA 99204Phone(509) 838-8610Fax(509) 835-4058Provider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicense27454WashingtonProvider IdentifiersIDDescriptionIssuerID1057546DescriptionMedicaidIssuerUnlistedWashington