| Sparks Psychiatry, Pllc | |
|
1500 Nw Bethany Blvd. Suite 200 Beaverton OR 97006 | |
| (503) 782-5651 | |
| Not Available |
| Full Name | Sparks Psychiatry, Pllc |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 1500 Nw Bethany Blvd., Beaverton, Oregon |
| Authorized Official Name and Position | Jody Pauwels (OWNER/MANAGER) |
| Authorized Official Contact | 5037825651 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sparks Psychiatry, Pllc 7698 Sw 143rd St Palmetto Bay FL 33158-1638 Ph: () - | Sparks Psychiatry, Pllc 1500 Nw Bethany Blvd. Suite 200 Beaverton OR 97006 Ph: (503) 782-5651 |
| NPI Number | 1700677358 |
|---|---|
| Provider Enumeration Date | 05/14/2025 |
| Last Update Date | 05/14/2025 |
| Certification Date | 05/01/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700677358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
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