Demographics
DOB: Aug 6, 1974
Sex: M
Status: active
Email: Shortk84@gmail.com
Mobile: 5035096436
Home: 5035096436
Department: WEST SALEM
Primary Provider: Emma Stacey
Last Synced: Jun 17, 2026, 2:13 PM
Address: 941 Chemawa Rd NE, KEIZER, OR, 97303-3715
Allergy (5)
| Type | Description | Onset / Date | Status |
|---|---|---|---|
| Allergy | — | — | |
| Allergy | Nov 6, 2019 | — | |
| Allergy | Oct 11, 2019 | — | |
| Allergy | May 20, 2019 | — | |
| Allergy | Apr 5, 2016 | — |
Problem (4)
| Type | Description | Onset / Date | Status |
|---|---|---|---|
| Problem | Sep 16, 2025 | — | |
| Problem | Sep 16, 2025 | — | |
| Problem | Sep 16, 2025 | — | |
| Problem | Sep 16, 2025 | — |
Vital (7)
| Type | Description | Onset / Date | Status |
|---|---|---|---|
| Vital | Aug 1, 2025 | — | |
| Vital | Aug 1, 2025 | — | |
| Vital | Aug 1, 2025 | — | |
| Vital | Aug 1, 2025 | — | |
| Vital | Aug 1, 2025 | — | |
| Vital | Aug 1, 2025 | — | |
| Vital | Aug 1, 2025 | — |
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