Individual
DR. SANDRA SHORTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3901 HOYT AVE, EVERETT, WA 98201-4918
(425) 339-5420
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 258-3900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301049061
MI
207R00000X
Internal Medicine Physician
Primary
MD00021927
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B56065004
MEDICARE PART B
MI
05
—
2037672
—
WA
05
—
4254388
—
MI
01
—
SS049061
HEALTH PLUS AND BCBS
MI
Enumeration date
01/23/2006
Last updated
11/21/2014
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