Individual
MICHAEL G GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 223-6600
Mailing address
1100 9TH AVE, MS M4-PA, SEATTLE, WA 98101-2756
(206) 515-5811
(206) 515-5886
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD00023724
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039572
LABOR & INDUSTRY
WA
01
—
004104300
IDAHO MEDICAID
WA
01
—
040008993
RAILROAD MEDICARE
WA
05
—
8105280
—
WA
01
—
GL3329
BLUE SHIELD
WA
01
—
MD7224
ALASKA MEDICAID
WA
01
—
US0862705
AETNA/USHC SPECIALIST
WA
Enumeration date
07/25/2006
Last updated
08/27/2013
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