Healthcare Provider Details

I. General information

NPI: 1104821693
Provider Name (Legal Business Name): SARAH ANN TRACY PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ANN SALZBERG PHARM.D.

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3855 MARTIN WAY E STE A
OLYMPIA WA
98506-5268
US

IV. Provider business mailing address

4060 AMELIA CT NE
LACEY WA
98516-5448
US

V. Phone/Fax

Practice location:
  • Phone: 360-810-3710
  • Fax:
Mailing address:
  • Phone: 360-481-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH00020486
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPH00020486
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00020486
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: