Healthcare Provider Details

I. General information

NPI: 1841552148
Provider Name (Legal Business Name): FRANCISCAN MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34503 9TH AVE S STE 330
FEDERAL WAY WA
98003-8727
US

IV. Provider business mailing address

34503 9TH AVE S STE 330
FEDERAL WAY WA
98003-8727
US

V. Phone/Fax

Practice location:
  • Phone: 253-838-5409
  • Fax: 253-661-1987
Mailing address:
  • Phone: 253-838-5409
  • Fax: 253-661-1987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN SPARE
Title or Position: PRESIDENT AND CMO
Credential: MD
Phone: 253-680-4008