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Individual

EILEEN MARIE SPARKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD, CDE

Contact information

Practice address
4855 SW WESTERN AVE, BEAVERTON, OR 97005-3460
(503) 520-4853
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
(800) 813-2000
(855) 524-5255

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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