Organization
FRANCISCAN MEDICAL GROUP
Active
Parent organization
FRANCISCAN MEDICAL GROUP
Other names
Lakes Family Medicine-Puyallup
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRANCISCAN MEDICAL GROUP
Authorized official
CLIFF A. ROBERTSON MD (PRESIDENT/ CHIEF MEDICAL OFFICER)
(253) 779-6101
Entity
Organization
Contact information
Practice address
10116 116TH ST E, STE 101, PUYALLUP, WA 98373-3543
(253) 864-0224
(253) 864-0634
Mailing address
10116 116TH ST E, STE 101, PUYALLUP, WA 98373-3543
(253) 864-0224
(253) 864-0634
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0224333
STATE L&I
WA
05
—
7139173
—
WA
Enumeration date
08/27/2007
Last updated
02/20/2008
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