Individual
GLENN N. ELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4309 W 27TH PL, SUITE 301, KENNEWICK, WA 99338-2904
(509) 222-2231
(509) 222-2232
Mailing address
7203 W DESCHUTES AVE, KENNEWICK, WA 99336-7777
(509) 737-1880
(509) 737-1879
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00043998
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8402364
—
WA
Enumeration date
05/18/2006
Last updated
07/12/2010
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