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General NPI Number Information
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NPI Number | 1326058017
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Entity Type | Organization
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Legal Business Name | FHS INPATIENT TEAM
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 02/05/2009
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Provider Practice Location Address
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Address Line | 34515 9TH AVE S
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City | FEDERAL WAY
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State | WA
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Zip | 98003-6761
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Country | US
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Telephone | 252-426-6341
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Fax | 253-426-6344
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Provider Business Mailing Address
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Address Line | 1717 S J ST
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City | TACOMA
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State | WA
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Zip | 98405-4933
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Country | US
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Telephone | 252-426-6341
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Fax | 253-426-6344
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Authorized Official
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Title or Position | VP, FINANCIAL OPS
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Name | MIKE FITZGERALD
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Credential |
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Telephone | 253-552-4105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD00013079
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License Number State | WA
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