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General NPI Number Information
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NPI Number | 1235284688
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Entity Type | Organization
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Legal Business Name | SPARKS CHIROPRACTIC INC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 4208 SW OREGON ST.
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City | SEATTLE
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State | WA
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Zip | 98116
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Country | US
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Telephone | 206-938-3175
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Fax | 206-938-1848
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Provider Business Mailing Address
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Address Line | 4208 SW OREGON ST.
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City | SEATTLE
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State | WA
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Zip | 98116
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Country | US
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Telephone | 206-938-3175
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Fax | 206-938-1848
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. CATHERINE JOY SPARKS
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Credential | D.C
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Telephone | 206-938-3175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2106
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License Number State | WA
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