Individual
SHANNON SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028
(509) 663-8711
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60664247
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164883286
—
WA
01
—
P01683026
RR PTAN WVH
WA
Enumeration date
03/16/2016
Last updated
09/07/2022
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