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 1:106 1ST ST S
Mailing Address - Street 2:PO BOX 5120
Mailing Address - City:YELM
Mailing Address - State:WA
Mailing Address - Zip Code:98597-7700
Mailing Address - Country:US
Mailing Address - Phone:360-458-8467
Mailing Address - Fax:360-458-3973
Practice Address - Street 1:106 1ST ST S
Practice Address - Street 2:
Practice Address - City:YELM
Practice Address - State:WA
Practice Address - Zip Code:98597-7700
Practice Address - Country:US
Practice Address - Phone:360-458-8467
Practice Address - Fax:360-458-3973
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000204861835P1200X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy