MEDICARE: FRANCISCAN MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0201042	OTHER	WA	STATE L&I
2	193293917	OTHER	WA	OWCP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	8906804	OTHER	WA	CRIME VICTIMS

General Provider Information

NPI Number	:	1649218959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANCISCAN MEDICAL GROUP

Provider Business Mailing Address
First Line	:	11511 CANTERWOOD BLVD NW
Second Line	:	STE 205
City	:	GIG HARBOR
State	:	WA
Zip	:	98332-5813
Country	:	US
Telephone Number	:	253-530-2663
Fax Number	:	253-530-2675

Provider Business Practice Location Address
First Line	:	11511 CANTERWOOD BLVD NW
Second Line	:	STE 205
City	:	GIG HARBOR
State	:	WA
Zip	:	98332-5813
Country	:	US
Telephone Number	:	253-530-2663
Fax Number	:	253-530-2675

Authorized Official
Title or Position	:	CHIEF MEDICAL OFFICER
Name	:	DR. CLIFF A ROBERTSON
Credential	:	MD
Telephone Number	:	253-779-6101

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	06/14/2010

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Directions to “FRANCISCAN MEDICAL GROUP ” Practice Location

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