Organization
FRANCISCAN MEDICAL GROUP
Active
Parent organization
FRANCISCAN MEDICAL GROUP
Other names
Franciscan Medical Clinic-Enumclaw
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
3021 GRIFFIN AVE, ENUMCLAW, WA 98022-2369
(360) 825-6511
Mailing address
3021 GRIFFIN AVE, ENUMCLAW, WA 98022-2369
(360) 825-6511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0126687
STATE L&I
WA
05
—
7093776
—
WA
05
—
7131584
—
WA
Enumeration date
07/02/2006
Last updated
07/02/2012
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