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Individual

DEAN SHORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
834 SHERIDAN ST, PORT TOWNSEND, WA 98368-2443
(360) 344-3090
(360) 344-3089
Mailing address
808 N 5TH AVE, SEQUIM, WA 98382-3045
(360) 683-5900
(360) 582-4800

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10005046
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8462178
WA
01
P00406337
RAILROAD MEDICARE
Enumeration date
08/19/2006
Last updated
03/15/2019
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