Provider Demographics
NPI:1417995895
Name:CORNERSTONE PROSTHETICS AND ORTHOTICS, INC
Entity Type:Organization
Organization Name:CORNERSTONE PROSTHETICS AND ORTHOTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-339-2559
Mailing Address - Street 1:1300 44TH ST SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-2200
Mailing Address - Country:US
Mailing Address - Phone:425-339-2559
Mailing Address - Fax:425-339-1583
Practice Address - Street 1:1300 44TH ST SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2200
Practice Address - Country:US
Practice Address - Phone:425-339-2559
Practice Address - Fax:425-339-1583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA600596756335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9018516Medicaid
WACO7974OtherREGENCE BELLINGHAM OFFICE
WA027038001OtherGROUP HEALTH
WA1010020Medicaid
WA2006562Medicaid
WA91118OtherLABOR AND INDUSTRIES
WACO8874OtherREGENCE EVERETT OFFICE
WA2006595Medicaid
WACO9974OtherREGENCE MOUNT VERNON OFFI
WA2006747Medicaid
WA8950LOOtherREGENCE EDMONDS OFFICE
WA9004717Medicaid
WA192166200OtherOWCP
WA2005840Medicaid
WA=========OtherCHOICE CARE
WA=========OtherFIRST CHOICE
WA=========OtherGREAT WEST
WA192166200OtherOWCP
WACO9974OtherREGENCE MOUNT VERNON OFFI
WA1010020Medicaid
WA9018516Medicaid