Individual
SARAH KW SPARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
65 N KELLER, REPUBLIC, WA 99166
(509) 775-3341
(509) 775-2937
Mailing address
65 N KELLER, REPUBLIC, WA 99166
(509) 775-3341
(509) 775-2937
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60871216
WA
175T00000X
Peer Specialist
Primary
CG60871216
WA
Other
Enumeration date
10/22/2018
Last updated
06/09/2022
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