Individual
PEGGY O SHORTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3901 HOYT AVE, EVERETT, WA 98201-4918
(425) 339-5412
(425) 259-1164
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 258-3900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30005632
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202016
LABOR AND INDUSTRIES
WA
05
—
1042641
—
WA
05
—
9641127
—
WA
Enumeration date
01/22/2007
Last updated
01/20/2021
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