Organization
FRANCISCAN MEDICAL GROUP
Active
Parent organization
FRANCISCAN MEDICAL GROUP
Other names
FMG-DuPont Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRANCISCAN MEDICAL GROUP
Authorized official
CLIFF A. ROBERTSON MD (CHIEF MEDICAL OFFICER)
(253) 779-6101
Entity
Organization
Contact information
Practice address
1175 CENTER DR, #130, DUPONT, WA 98327-7733
(253) 539-9735
(253) 539-7981
Mailing address
1175 CENTER DR, #130, DUPONT, WA 98327-7733
(253) 964-5260
(253) 964-5266
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00002173
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0217715
STATE L&I
WA
05
—
7136674
—
WA
05
—
7137136
—
WA
Enumeration date
02/20/2007
Last updated
06/20/2008
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