Healthcare Provider Details

I. General information

NPI: 1932412293
Provider Name (Legal Business Name): FRANCISCAN MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2010
Last Update Date: 07/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1742 MARKET ST STE 102
TACOMA WA
98402-3213
US

IV. Provider business mailing address

1900 COMMERCE ST BOX 358423
TACOMA WA
98402-3112
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 Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DEAN FIELD
Title or Position: PRESIDENT, CMO
Credential: MD
Phone: 253-680-4009