Provider Demographics
NPI:1447490123
Name:FRANCISCAN HEALTH SYSTEM
Entity type:Organization
Organization Name:FRANCISCAN HEALTH SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-680-4005
Mailing Address - Street 1:1717 S J ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4933
Mailing Address - Country:US
Mailing Address - Phone:253-985-6560
Mailing Address - Fax:253-985-6511
Practice Address - Street 1:11307 BRIDGEPORT WAY SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3024
Practice Address - Country:US
Practice Address - Phone:253-426-4600
Practice Address - Fax:253-426-4601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCSICAN HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-20
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7146277Medicaid
WAG8854508Medicare PIN