Healthcare Provider Details

I. General information

NPI: 1427378322
Provider Name (Legal Business Name): FRANCISCAN MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 YAKIMA AVE STE 208
TACOMA WA
98405-5304
US

IV. Provider business mailing address

1802 YAKIMA AVE STE 208
TACOMA WA
98405-4499
US

V. Phone/Fax

Practice location:
  • Phone: 253-985-2722
  • Fax: 253-985-2853
Mailing address:
  • Phone: 253-985-2722
  • Fax: 253-985-2853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DEAN FIELD
Title or Position: CMO
Credential: MD
Phone: 253-680-4009