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DR. MATTHEW MAXWELL KELLOGG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3600 NW SAMARITAN DR, CORVALLIS, OR 97330-5472
(541) 757-5111
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD26009
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
213509
OR
05
8429359
WA
01
P00412469
RR MEDICARE
OR
Enumeration date
05/17/2006
Last updated
07/24/2023
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