Provider Demographics
NPI:1104821693
Name:TRACY, SARAH ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ANN
Last Name:TRACY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:SALZBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4060 AMELIA CT NE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-5448
Mailing Address - Country:US
Mailing Address - Phone:360-481-3300
Mailing Address - Fax:
Practice Address - Street 1:3855 MARTIN WAY E STE A
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5268
Practice Address - Country:US
Practice Address - Phone:360-810-3710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000204861835P0018X, 1835P1200X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy