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General NPI Number Information
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NPI Number | 1538313036
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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 | 11/11/2008
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 11511 CANTERWOOD BLVD NW SUITE 100
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City | GIG HARBOR
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State | WA
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Zip | 98332
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Country | US
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Telephone | 253-530-2610
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Fax | 253-530-2619
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Provider Business Mailing Address
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Address Line | 11511 CANTERWOOD BLVD NW SUITE 100
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City | GIG HARBOR
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State | WA
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Zip | 98332
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Country | US
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Telephone | 253-530-2610
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Fax | 253-530-2619
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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 |
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Telephone | 253-779-6101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00039111
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License Number State | WA
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