Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Spark Med Spa, LLC

Organization Health Service Clinic/Center · NPI 1376246884

Spark Med Spa, LLC is a Health Service Clinic/Center in Hayden, Idaho. Works from 2 locations. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8027 N Government Way Ste 106
Hayden, ID 83835
Phone: (208) 241-9422
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1352 E Center St Ste B, Pocatello, ID 83201-4702 — (208) 241-9942

Specialties & licences

Health Service Clinic/Center (primary) Taxonomy 261QH0100X

Record details

NPI number1376246884
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSpark Med Spa, LLC
Authorized official Robbie Garrett — Co-Owner/Director · (208) 251-2660
Other names Spark Med Spa; Spark Med Spa
NPI enumeratedMarch 23, 2023
Last updated in NPPESMay 28, 2025
Certification dateMay 16, 2025
Mailing addressPo Box 1021, Athol, ID 83801-6009

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