Individual
KELCIE SHORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3717 GRANDVIEW DR W, UNIVERSITY PLACE, WA 98466-2138
(253) 566-5600
Mailing address
166 HARVARD AVE, FIRCREST, WA 98466-7416
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SP60667844
—
WA
Enumeration date
11/13/2020
Last updated
11/13/2020
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