1023248382 NPI number — FRANCISCAN MEDICAL GROUP

Table of content: (NPI 1023248382)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023248382 NPI number — FRANCISCAN MEDICAL GROUP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANCISCAN MEDICAL GROUP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023248382
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3315 S 23RD ST
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
TACOMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98405-1605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-552-1200
Provider Business Mailing Address Fax Number:
253-552-1239

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3315 S 23RD ST
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98405-1605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-552-1200
Provider Business Practice Location Address Fax Number:
253-552-1239
Provider Enumeration Date:
07/21/2009

Additional Information

Authorized Official

Authorized Official Last Name:
FIELD
Authorized Official First Name:
DEAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF MEDICAL OFFICER
Authorized Official Telephone Number:
253-858-9192

Provider Taxonomy Codes

  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com