Organization
FRANCISCAN MEDICAL GROUP
Active
Parent organization
FRANCISCAN MEDICAL GROUP
Other names
Surprise Lake Medical Clinic
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
2748 MILTON WAY, STE 101, MILTON, WA 98354-9382
(253) 922-5262
(253) 922-5299
Mailing address
2748 MILTON WAY, STE 101, MILTON, WA 98354-9382
(253) 922-5262
(253) 922-5299
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0105765
STATE L&I
WA
05
—
7124365
—
WA
Enumeration date
07/30/2006
Last updated
06/14/2010
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