NPI 1003899493

Kevin Ryan Kellogg, PAC

Practitioner Surgical Physician Assistant Spokane Valley, WA

Practice location

Address: 16528 Desmet CT, Spokane Valley, WA 99216-3522
Phone: (509) 944-8920
Fax: (509) 227-7070
Mailing address: PO Box 421, Liberty Lake, WA 99019-0421

Registered specialties

Surgical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AS0400X Licence PA10005240 (WA)

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Registry record

NPI: 1003899493
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Nov 2005
Record last updated: 1 Mar 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.