Individual
DR. WILL KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 985-6403
(253) 985-6879
Mailing address
1717 S J ST, TACOMA, WA 98405-4933
(253) 985-6403
(253) 985-6879
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00034368
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0127354
LABOR& INDUSTRIES
WA
05
—
1107614
—
WA
01
—
8935812
CRIME VICTIMS
WA
01
—
KE5497
REGENCE BLUESHIELD
WA
Enumeration date
06/21/2006
Last updated
10/08/2024
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