Provider Demographics
NPI:1326308339
Name:SPARROW, NATASHA G (DO)
Entity Type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:G
Last Name:SPARROW
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0421
Mailing Address - Country:US
Mailing Address - Phone:866-747-2455
Mailing Address - Fax:
Practice Address - Street 1:105 W 8TH AVE STE 318C
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2318
Practice Address - Country:US
Practice Address - Phone:509-474-6650
Practice Address - Fax:509-474-6646
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTL00058972084N0400X
WAOP607231682084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology