Provider Demographics
NPI:1437408655
Name:SPARKER, CHRISTINA (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:SPARKER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 86TH AVE. SE
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-4198
Mailing Address - Country:US
Mailing Address - Phone:206-232-8680
Mailing Address - Fax:206-232-9377
Practice Address - Street 1:4030 86TH AVE. SE
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-4198
Practice Address - Country:US
Practice Address - Phone:206-232-8680
Practice Address - Fax:206-232-9377
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-04
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00004283225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist