Provider Demographics
NPI:1669455531
Name:JADE, SARA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:JADE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SARA
Other - Middle Name:ANN
Other - Last Name:JUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3018 NE 125TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4413
Mailing Address - Country:US
Mailing Address - Phone:206-362-7572
Mailing Address - Fax:
Practice Address - Street 1:4727 DENVER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98134-2316
Practice Address - Country:US
Practice Address - Phone:206-763-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP45734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist