Healthcare Provider Details

I. General information

NPI: 1184911869
Provider Name (Legal Business Name): FRANCISCAN MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2011
Last Update Date: 07/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6002 WESTGATE BLVD STE 230
TACOMA WA
98406-2570
US

IV. Provider business mailing address

6002 WESTGATE BLVD STE 230
TACOMA WA
98406-2570
US

V. Phone/Fax

Practice location:
  • Phone: 253-761-2244
  • Fax: 253-761-1040
Mailing address:
  • Phone: 253-761-2244
  • Fax: 253-761-1040

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 V SPARE
Title or Position: PRESIDENT, CMO
Credential: MD
Phone: 253-680-4009