Provider Demographics
NPI:1124062997
Name:FRANCISCAN HEALTH SYSTEM
Entity type:Organization
Organization Name:FRANCISCAN HEALTH SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCIAL OPS
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-552-4105
Mailing Address - Street 1:1802 YAKIMA AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4499
Mailing Address - Country:US
Mailing Address - Phone:253-272-7777
Mailing Address - Fax:253-426-4142
Practice Address - Street 1:1802 YAKIMA AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4499
Practice Address - Country:US
Practice Address - Phone:253-272-7777
Practice Address - Fax:253-426-4142
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCISCAN HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-15
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACU0613OtherMEDICARE RAILROAD
WA8939625OtherCRIME VICTIMS
WA0191190OtherSTATE L&I
WAGAB07438OtherLEGACY
WAP00625530OtherRR MEDICARE
WA0292620OtherL&I
WA7125818Medicaid
WA0293927OtherL&I
WAG8868766OtherMEDICARE
WA0293927OtherL&I