Franciscan Health System
Organization Active NPI Psychologist · Lakewood, WA
NPI 1093952145 · NPPES record last updated Feb 5, 2009
Key facts
- NPI
- 1093952145
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- Legal business name
- FRANCISCAN HEALTH SYSTEM
- Practice address
- 4908 112TH St SW
Lakewood, WA 98499-5143 - Phone
- (253) 985-6560
- Fax
- (253) 985-6561
- NPI assigned
- Jan 12, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- FRANCISCAN HEALTH SYSTEM
Authorized official
- Name
- Mike Fitzgerald
- Title
- VP Financial Ops
- Phone
- (253) 680-4005
Other NPIs on the same Medicare enrollment 26
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040209000147 | WA | Part B Supplier - Clinic/Group Practice | 1557254935 |
Receives reassigned benefits from 27 practitioners 26 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Tacoma, WA; University Place, WA; Silverdale, WA; Puyallup, WA; Lakewood, WA; Gig Harbor, WA |
National Provider Directory
- Part of
- Franciscan HLTH System West
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | Yes |
Addresses
Primary practice location
4908 112TH St SW
Lakewood, WA 98499-5143
Mailing address
4908 112TH St SW
Lakewood, WA 98499-5143
Phone (253) 985-6560
Other names
- Franciscan Psychology-Neuropsychology Services @ St Clare
Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.