Provider Demographics
NPI:1093952145
Name:FRANCISCAN HEALTH SYSTEM
Entity Type:Organization
Organization Name:FRANCISCAN HEALTH SYSTEM
Other - Org Name:FRANCISCAN PSYCHOLOGY-NEUROPSYCHOLOGY SERVICES @ ST CLARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCIAL OPS
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 1:4908 112TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-5143
Mailing Address - Country:US
Mailing Address - Phone:253-985-6560
Mailing Address - Fax:253-985-6561
Practice Address - Street 1:4908 112TH ST SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-5143
Practice Address - Country:US
Practice Address - Phone:253-985-6560
Practice Address - Fax:253-985-6561
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCISCAN HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-12
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty