Healthcare Provider Details

I. General information

NPI: 1750529244
Provider Name (Legal Business Name): FRANCISCAN MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 01/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1624 S I ST
TACOMA WA
98405-5016
US

IV. Provider business mailing address

1624 S I ST
TACOMA WA
98405-5016
US

V. Phone/Fax

Practice location:
  • Phone: 253-779-6215
  • Fax: 253-779-6191
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: CLIFF ROBERTSON
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 253-680-4015