Provider Demographics
NPI:1730463423
Name:FIFAREK, SARA J (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:J
Last Name:FIFAREK
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 1:2939 OCEAN BEACH HWY
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-3513
Mailing Address - Country:US
Mailing Address - Phone:360-232-1021
Mailing Address - Fax:
Practice Address - Street 1:2939 OCEAN BEACH HWY
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3513
Practice Address - Country:US
Practice Address - Phone:360-232-1021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61164640183500000X
CO18506183500000X
CA76194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist