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Individual
EILEEN MARIE SPARKS
Active
Individual
EILEEN MARIE SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDE
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
DI60643012
WA
133V00000X
Registered Dietitian
Primary
LDD000457
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
930798039
—
OR
01
—
95832421
DRIVER LICENSE
OR
Enumeration date
07/23/2008
Last updated
12/17/2025
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