Provider Demographics
NPI:1851648877
Name:DUSKY, SARA RENEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:RENEE
Last Name:DUSKY
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 1:690 GAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9512
Mailing Address - Country:US
Mailing Address - Phone:509-627-5133
Mailing Address - Fax:509-627-1736
Practice Address - Street 1:690 GAGE BLVD
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-9512
Practice Address - Country:US
Practice Address - Phone:509-627-5133
Practice Address - Fax:509-627-1736
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA70400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist