Provider Demographics
NPI:1619304763
Name:QUACH, SARA T (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:T
Last Name:QUACH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15995 SW WALKER RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-4910
Mailing Address - Country:US
Mailing Address - Phone:503-690-5833
Mailing Address - Fax:503-690-5827
Practice Address - Street 1:15995 SW WALKER RD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-4910
Practice Address - Country:US
Practice Address - Phone:503-690-5833
Practice Address - Fax:503-690-5827
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60389153183500000X, 1835P0018X
ORPH00141081835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist