Healthcare Provider Details

I. General information

NPI: 1316251747
Provider Name (Legal Business Name): FRANCISCAN MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11511 CANTERWOOD BLVD NW STE 145
GIG HARBOR WA
98332-5813
US

IV. Provider business mailing address

11511 CANTERWOOD BLVD NW STE 145
GIG HARBOR WA
98332-5813
US

V. Phone/Fax

Practice location:
  • Phone: 253-552-4102
  • Fax: 253-552-4175
Mailing address:
  • Phone: 253-552-4102
  • Fax: 253-552-4175

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: DEAN FIELD
Title or Position: PRESIDENT, CMO
Credential: MD
Phone: 253-608-4009