Organization
FRANCISCAN MEDICAL GROUP
Active
Parent organization
FRANCISCAN MEDICAL GROUP
Other names
Franciscan Medical Clinic-Canyon Road
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRANCISCAN MEDICAL GROUP
Authorized official
DEAN FIELD MD (CMO)
(253) 680-4009
Entity
Organization
Contact information
Practice address
15214 CANYON RD E, STE 100, PUYALLUP, WA 98375-7472
(253) 539-4200
Mailing address
15214 CANYON RD E, STE 100, PUYALLUP, WA 98375-7472
(253) 539-4200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0255554
L&I
WA
01
—
106101536
OWCP
—
01
—
GAB08472
MEDICARE
WA
Enumeration date
08/17/2009
Last updated
07/02/2012
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