Individual
SHAYNE LEON SPARROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PARAMEDIC
Contact information
Practice address
9040 JACKSON AVE ATTN: MCHJ-CLQ-C, TACOMA, WA 98431-0001
(253) 968-0940
Mailing address
207 TERRACE CT, VANDENBERG AFB, CA 93437-1437
(504) 430-2005
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
M0983833
—
Other
Enumeration date
05/22/2018
Last updated
05/22/2018
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