Individual
MARTHA L SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
550 17TH AVE, STE 500, SEATTLE, WA 98122-5788
(206) 320-2800
(206) 320-2827
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004271
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201547
LABOR AND INDUSTRIES
WA
05
—
84323790
—
WA
Enumeration date
12/21/2006
Last updated
03/28/2016
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