Provider Demographics
NPI:1366897837
Name:SPARROW, JOANNE KATHRINA (PHD)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:KATHRINA
Last Name:SPARROW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8641 236TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-1977
Mailing Address - Country:US
Mailing Address - Phone:510-593-5424
Mailing Address - Fax:
Practice Address - Street 1:3429 FREMONT AVE N STE 317
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8811
Practice Address - Country:US
Practice Address - Phone:206-300-2452
Practice Address - Fax:206-547-5298
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60918972103TC0700X
NM390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program