Provider Demographics
NPI:1861748675
Name:FRANCISCAN MEDICAL GROUP
Entity type:Organization
Organization Name:FRANCISCAN MEDICAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CMO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPARE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-792-4344
Mailing Address - Street 1:34503 9TH AVE S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8727
Mailing Address - Country:US
Mailing Address - Phone:253-874-2227
Mailing Address - Fax:253-835-8035
Practice Address - Street 1:34503 9TH AVE S
Practice Address - Street 2:SUITE 100
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8727
Practice Address - Country:US
Practice Address - Phone:253-874-2227
Practice Address - Fax:253-835-8035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty