Provider Demographics
NPI:1396234506
Name:SPARKS, ASHLEY (DO)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:SPARKS
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 1:10667 NE 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-5727
Mailing Address - Country:US
Mailing Address - Phone:425-419-0812
Mailing Address - Fax:425-272-9370
Practice Address - Street 1:188 106TH AVE NE STE 402
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6896
Practice Address - Country:US
Practice Address - Phone:425-419-0812
Practice Address - Fax:425-272-9370
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP61471937207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine