Provider Demographics
NPI:1386864593
Name:SLOT, FRANCHOT (MD/PHD)
Entity type:Individual
Prefix:DR
First Name:FRANCHOT
Middle Name:
Last Name:SLOT
Suffix:
Gender:M
Credentials:MD/PHD
Other - Prefix:DR
Other - First Name:FRANCHOT
Other - Middle Name:VAN
Other - Last Name:SLOT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD/PHD
Mailing Address - Street 1:315 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4234
Mailing Address - Country:US
Mailing Address - Phone:253-403-1291
Mailing Address - Fax:253-403-1374
Practice Address - Street 1:315 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4234
Practice Address - Country:US
Practice Address - Phone:253-403-1291
Practice Address - Fax:253-403-1374
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27710208M00000X, 207Q00000X
WAMD00063873208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR007172Medicaid
WAMD00063873OtherWA LICENSE
ORMD27710OtherOREGON MEDICAL BOARD
WAMD00063873OtherWA LICENSE