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General NPI Number Information
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NPI Number | 1902854029
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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 | 05/04/2006
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Last Update Date | 12/11/2008
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Provider Practice Location Address
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Address Line | 34503 9TH AVE S STE 100
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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 | 253-874-2227
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Fax | 253-835-8000
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Provider Business Mailing Address
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Address Line | 34503 9TH AVE S STE 100
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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 | 253-874-2227
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Fax | 253-835-8000
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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 | 253-779-6101
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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 | MD00042134
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License Number State | WA
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