Provider Demographics
NPI:1689000267
Name:DUBOIS, SARAH MARION (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARION
Last Name:DUBOIS
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 1:6 E 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1503
Mailing Address - Country:US
Mailing Address - Phone:509-624-3017
Mailing Address - Fax:
Practice Address - Street 1:6 E 1ST AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1503
Practice Address - Country:US
Practice Address - Phone:509-624-3017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60359530183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist