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General NPI Number Information
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NPI Number | 1629016936
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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 | 06/02/2006
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 1708 YAKIMA AVE STE 202
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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 | 253-426-6878
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Fax | 253-426-4254
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Provider Business Mailing Address
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Address Line | 1708 YAKIMA AVE STE 202
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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 | 253-426-6878
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Fax | 253-426-4254
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. CLIFF A ROBERTSON
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Credential | MD
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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 | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | MD00023541
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License Number State | WA
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