Individual
MATTHEW WILLIAM SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 ROS CIR, REPUBLIC, WA 99166-5002
(509) 775-3153
Mailing address
10 ROS CIR, REPUBLIC, WA 99166-5002
(509) 775-3153
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD61107739
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
331-8907
—
WA
Enumeration date
07/09/2008
Last updated
09/08/2021
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