Healthcare Provider Details

I. General information

NPI: 1285682492
Provider Name (Legal Business Name): FRANCISCAN HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 07/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 S J ST
TACOMA WA
98405-4933
US

IV. Provider business mailing address

1717 S J ST
TACOMA WA
98405-4933
US

V. Phone/Fax

Practice location:
  • Phone: 253-426-4020
  • Fax: 253-426-6610
Mailing address:
  • Phone: 253-426-4020
  • Fax: 253-426-6610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: MIKE FITZGERALD
Title or Position: UP FINANCIAL OPS
Credential:
Phone: 253-552-4105