Individual
DEAN SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
16760 N HIGHWAY 41, RATHDRUM, ID 83858-8715
(208) 687-5627
(844) 807-3782
Mailing address
14402 E SPRAGUE AVE, SPOKANE VALLEY, WA 99216-2167
(509) 922-2625
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA16890
CA
363AM0700X
Medical Physician Assistant
Primary
PA-2073
ID
363AM0700X
Medical Physician Assistant
PA60599094
WA
Other
Enumeration date
08/11/2006
Last updated
08/14/2023
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