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NPI 1104821693

NPI 1104821693 : SARAH ANN TRACY PHARM.D. : OLYMPIA, WA

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General NPI Number Information
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    NPI Number           |    1104821693
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    Entity Type          |    Individual 
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    Provider Name        |    SARAH ANN TRACY PHARM.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/20/2005
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    Last Update Date     |    07/31/2025
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Provider Practice Location Address
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    Address Line         |    3855 MARTIN WAY E STE A 
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    City                 |    OLYMPIA
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    State                |    WA
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    Zip                  |    98506-5268
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    Country              |    US
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    Telephone            |    360-810-3710
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4060 AMELIA CT NE 
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    City                 |    LACEY
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    State                |    WA
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    Zip                  |    98516-5448
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    Country              |    US
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    Telephone            |    360-481-3300
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1835P0018X
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    Taxonomy Name        |    Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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    License Number       |    PH00020486
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    License Number State |    WA
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Taxonomy #2
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    Taxonomy Code        |    1835P1200X
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    Taxonomy Name        |    Pharmacotherapy Pharmacist
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    License Number       |    PH00020486
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    License Number State |    WA
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Taxonomy #3
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    PH00020486
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    License Number State |    WA
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