# FRANCISCAN MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Franciscan Medical Clinic-Bonney Lake
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497194922
- **Authorized official:** ROBERTA JO WITTORF (REGIONAL VP FINANCE, NORTHWEST)
- **Authorized official phone:** (509) 551-5319

## Contact information

- **Practice address:** 9230 SKY ISLAND DR E, BONNEY LAKE, WA 98391-7385
- **Practice address phone:** (253) 750-6000
- **Mailing address:** 9230 SKY ISLAND DR E, BONNEY LAKE, WA 98391-7385
- **Mailing address phone:** (253) 750-6000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/18/2013
- **Last updated:** 09/29/2026