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Organization

FRANCISCAN MEDICAL GROUP

Active
Parent organization
FRANCISCAN MEDICAL GROUP
Other names
NW Neurology
Organization subpart
Yes

Provider details

NPI number
Legal business name
FRANCISCAN MEDICAL GROUP
Authorized official
CLIFF ROBERTSON (CHIEF MEDICAL OFFICER)
(253) 779-6101
Entity
Organization

Contact information

Practice address
11311 BRIDGEPORT WAY SW, STE 301, LAKEWOOD, WA 98499-3071
(253) 512-2744
(253) 512-2853
Mailing address
11311 BRIDGEPORT WAY SW, STE 301, LAKEWOOD, WA 98499-3071
(253) 512-2744
(253) 512-2853

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0216109
STATE L&I
WA
05
7118185
WA
Enumeration date
08/02/2006
Last updated
06/12/2012
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