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Individual
VICKI L SHORT
Active
Individual
VICKI L SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00036610
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8231367
—
WA
Enumeration date
01/05/2006
Last updated
07/21/2022
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