Healthcare Provider Details

I. General information

NPI: 1952103939
Provider Name (Legal Business Name): SPARROW HEALTH & WELLNESS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11707 E SPRAGUE AVE STE LL101
SPOKANE VALLEY WA
99206-6110
US

IV. Provider business mailing address

11707 E SPRAGUE AVE STE LL101
SPOKANE VALLEY WA
99206-6110
US

V. Phone/Fax

Practice location:
  • Phone: 509-506-4600
  • Fax: 509-219-3835
Mailing address:
  • Phone: 509-506-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTI NANCE
Title or Position: CEO
Credential: NP
Phone: 509-506-4600