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General NPI Number Information
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NPI Number | 1821105271
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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 | 08/23/2006
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 34503 9TH AVE S STE 200
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City | FEDERAL WAY
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State | WA
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Zip | 98003-8727
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Country | US
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Telephone | 253-835-6260
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Fax | 253-835-6299
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Provider Business Mailing Address
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Address Line | 34503 9TH AVE S STE 200
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City | FEDERAL WAY
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State | WA
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Zip | 98003-8727
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Country | US
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Telephone | 253-835-6260
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Fax | 253-835-6299
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Authorized Official
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Title or Position | CMO, PRESIDENT
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Name | CLIFF 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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