FRANCISCAN MEDICAL GROUP (NPI# 1659628691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659628691 |
| Entity Type | Organization |
| Organization Name | FRANCISCAN MEDICAL GROUP |
| Other Organization Name | FRANCISCAN VASCULAR ASSOCIATES |
| Practice Address |
11307 Bridgeport Way Sw Suite 210 Lakewood WA 98499-3024 |
| Practice Telephone | 2539856160 |
| Practice Fax Number | 2539856165 |
| Mailing Telephone | 2539856160 |
| Mailing Fax Number | 2539856165 |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2012-08-09 |
| Authorized Official Name | STEPHEN SPARE (PRESIDENT AND CMO) |
| Authorized Official Telephone | 2537924344 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Franciscan Vascular Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629602016 | Franciscan Medical Group | Emergency Medicine | 3556 Market Pl W Ste 109, University Place, WA 98466-4339 | 2020-02-25 |
| 1497194922 | Franciscan Medical Group | Nurse Practitioner | 9230 Sky Island Drive E, Bonney Lake, WA 98391-7187 | 2013-06-18 |
| 1588944474 | Franciscan Medical Group | Internal Medicine | 424 29th St Ne, Ste D, Puyallup, WA 98372-6766 | 2011-08-23 |
| 1639405137 | Franciscan Medical Group | Podiatrist | 6401 Kimball Dr Nw, Ste 201, Gig Harbor, WA 98335-1228 | 2009-10-19 |
| 1093945677 | Franciscan Medical Group | Plastic Surgery | 11311 Bridgept Way Sw, Ste 309, Lakewood, WA 98499-3071 | 2009-07-17 |
| 1437397361 | Franciscan Medical Group | Physical Medicine & Rehabilitation | 1624 S. I St., Ste 205, Tacoma, WA 98405-5000 | 2009-01-30 |
| 1801051404 | Franciscan Medical Group | Surgery | 710 S 348th St, Ste A, Federal Way, WA 98003-7042 | 2008-07-23 |
| 1366539421 | Franciscan Medical Group | Family Medicine | 1717 S J St # Ms 20-15, Tacoma, WA 98405-4933 | 2006-10-09 |
| 1134237696 | Franciscan Medical Group | Surgery | 200 S 333rd St, Ste 150, Federal Way, WA 98003-7359 | 2006-08-26 |
| 1164437851 | Franciscan Medical Group | Podiatrist | 200 Auburn Ave, Auburn, WA 98002-5015 | 2006-07-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | FRANCISCAN MEDICAL GROUP | 2420 S State St, Ms: 20-15, Tacoma, WA 98405-2845 |
| System for Award Management (SAM) Entities | FRANCISCAN MEDICAL GROUP | 1717 S J St, Tacoma, WA 98405-4933 |
| Street Address |
11307 BRIDGEPORT WAY SW SUITE 210 |
| City | LAKEWOOD |
| State | WA |
| Zip Code | 98499-3024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952389702 | W Pierre Andrade | Allergy & Immunology | 11307 Bridgeport Way Sw, Ste 200, Lakewood, WA 98499-3004 | 2006-01-03 |
| 1003147869 | Franciscan Medical Group | Urology | 11307 Bridgeport Way Sw, Suite 217, Lakewood, WA 98499-3024 | 2010-01-19 |
| 1497084842 | Mohamed Imam El Bahy Imam | Internal Medicine | 11307 Bridgeport Way Sw, Lakewood, WA 98499-3024 | 2009-12-14 |
| 1447490123 | Franciscan Health System | Nurse Practitioner | 11307 Bridgeport Way Sw, Lakewood, WA 98499-3024 | 2009-02-20 |
| 1053559682 | Franciscan Medical Group | Surgery | 11307 Bridgeport Way Sw, Ste 220, Lakewood, WA 98499-3024 | 2009-02-04 |
| 1396820536 | Chad Farley | Podiatrist | 11307 Bridgeport Way Sw, Ste 220a, Lakewood, WA 98499-3024 | 2006-10-26 |
| 1457461410 | Allergy & Asthma Specialty Service Ps | Allergy & Immunology | 11307 Bridgeport Way Sw, Suite 200, Lakewood, WA 98499-3024 | 2006-08-30 |
| 1710996012 | Kristen M Costello | Physical Therapist | 11307 Bridgeport Way Sw, Ste 220, Lakewood, WA 98499-3024 | 2006-08-05 |
| 1902814833 | Franciscan Medical Group | Podiatrist | 11307 Bridgeport Way Sw, Ste 220-a, Lakewood, WA 98499-3024 | 2006-08-04 |
| 1457367377 | Carol D Ferguson | Physical Therapist | 11307 Bridgeport Way Sw, Ste 220, Lakewood, WA 98499-3024 | 2006-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159592 | Sea Mar Community Health Centers | Clinic/Center | 5700 100th Street Se, Suite 510, Lakewood, WA 98499 | 2020-06-23 |
| 1568018828 | Heather Leigh Andrade | Behavioral Analyst | 6210 75th St W Ste 100, Lakewood, WA 98499 | 2019-08-13 |
| 1043870876 | Seoul Chinese Herbs Inc | Acupuncturist | 8705 S. Tacoma Way, Lakewood, WA 98499 | 2019-06-14 |
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1447736657 | Marcela Cunan | Counselor | 9330 59th Avenue Southest, Lakewood, WA 98499 | 2018-07-11 |
| 1609382381 | Leroy Moore IIi | Counselor | 8811 S. Tacoma Way, 106, Lakewood, WA 98499 | 2017-12-18 |
| 1578077657 | Andrea Gaston | Behavior Technician | 8815 S. Tacoma Way, Suite 122, Lakewood, WA 98499 | 2017-11-27 |
| 1609389931 | Jennifer King | Social Worker | 5900 100th St Sw Ste 17b, Lakewood, WA 98499 | 2017-11-08 |
| 1750806337 | Wonyoung Lee | Counselor | 8811 South Tacoma Way, Suite 106, Lakewood, WA 98499 | 2017-08-04 |
| 1043749443 | Frederick Paltron Edwards | Counselor | 9500 Front Street, Suite 100, Lakewood, WA 98499 | 2017-06-08 |
| Find all providers in zip 98499 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992341895 | Surgicalist of Ca PC | Surgery | 3300 E South St Ste 301a, Lakewood, CA 90805-4549 | 2019-11-26 |
| 1407929185 | Mahadevan G Krishnan, Md PC | Surgery | 609 River Ave, Lakewood, NJ 08701-5227 | 2006-11-17 |
| 1134563638 | Tri Star Orthopaedics | Surgery | 5220 Clark Ave, 100, Lakewood, CA 90712-2618 | 2013-04-26 |
| 1578866943 | Catholic Health Initiatives Colorado | Surgery | 11700 West 2nd Place, Suite 210b, Lakewood, CO 80228 | 2010-12-07 |
| 1699849620 | Mahadevan G Krishnan | Surgery | 609 River Ave, Lakewood, NJ 08701-5227 | 2006-11-20 |
| 1780657924 | Vascular Surgery Nw Ps | Surgery | 11311 Bridgeport Way Sw, #203, Lakewood, WA 98499 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710496922 | Sunnyside Community Hospital Association | Surgery | 1005 W Walnut St Ste 201, Yakima, WA 98902-3384 | 2017-09-20 |
| 1750762415 | Anna Ohlsson | Surgery | 325 9th Ave # 359908, Seattle, WA 98104-2420 | 2015-06-17 |
| 1356722938 | Usa Vascular Centers of Kent Pllc | Surgery | 26124a Pacific Hwy S Ste A, Kent, WA 98032-6910 | 2015-06-09 |
| 1154602084 | Memorial Physicians, Pllc | Surgery | 1812 E Edison Ave, Sunnyside, WA 98944-1653 | 2011-09-06 |
| 1528387941 | Sara Jane Wasilenko | Surgery | 128 Lilly Rd Ne Ste 205, Olympia, WA 98506-7400 | 2010-05-25 |
| 1801051404 | Franciscan Medical Group | Surgery | 710 S 348th St, Ste A, Federal Way, WA 98003-7042 | 2008-07-23 |
| 1013104165 | John S Arthur | Surgery | 2528 Wheaton Way Ste 101, Bremerton, WA 98310-3305 | 2007-10-02 |
| 1891986097 | Vascular Associates, Ps | Surgery | 801 Broadway Ste 522, Seattle, WA 98122-4325 | 2007-08-05 |
| 1447464730 | Mai Thanh Pham | Surgery | 1229 Madison St Suite # 1190, Seattle, WA 98104 | 2007-05-09 |
| 1649491481 | Dae Young Lee | Surgery | 1100 Goethals Drive 3rd Floor, Kadlec Clinic Vascular Surgery, Richland, WA 99352-3304 | 2007-05-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.