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General NPI Number Information
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NPI Number | 1407805716
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Entity Type | Organization
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Legal Business Name | FRANCISCAN MEDICAL GROUP
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Dates
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Enumeration Date | 05/06/2006
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Last Update Date | 08/01/2011
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Provider Practice Location Address
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Address Line | 1708 YAKIMA AVE SUITE 112
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City | TACOMA
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State | WA
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Zip | 98405-5307
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Country | US
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Telephone | 253-627-6731
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Fax | 253-627-1064
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Provider Business Mailing Address
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Address Line | 1708 YAKIMA AVE SUITE 112
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City | TACOMA
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State | WA
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Zip | 98405-5307
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Country | US
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Telephone | 253-627-6731
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Fax | 253-627-1064
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | CLIFF ROBERTSON
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Credential | MD
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Telephone | 253-207-4854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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